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Abstract: FR-PO1151

A Modified Charlson Comorbidity Index (CCI) for Predicting Kidney Transplant Outcomes in the Elderly

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Sholi, Adam N., Weill Cornell Medicine, New York, New York, United States
  • Kamel, Mohamed K., Weill Cornell Medicine, New York, New York, United States
  • Kim, Jim, Weill Cornell Medicine, New York, New York, United States
  • Sultan, Samuel, Weill Cornell Medicine, New York, New York, United States
  • Watkins, Anthony, Weill Cornell Medicine, New York, New York, United States
Background

Contemporary kidney transplant recipients are older and tend to have significant comorbidities. However, the impact of comorbidities in elderly kidney recipients is unclear. This study used a modified Charlson comorbidity index (CCI) to compare the clinical features of elderly patients surviving < 3 years versus those with post-transplant survival > 3 years.

Methods

A prospective database was reviewed for patients aged >70 years undergoing deceased donor renal transplantation from 2007 – 2016. A modified CCI score was used designating 3 points for history of myocardial infarction and heart failure, traditional comorbidities as 1 point, and excluded renal disease. Multivariable analysis identified predictors of 3-year mortality.

Results

Among 114 elderly patients undergoing transplantation, 43 (38%) had 1 comorbidity and 39 (34%) had >2 comorbidities. The most common comorbidities were diabetes (45%), heart disease (39%), and peripheral vascular disease (18%). Patients were stratified based on 3-year post-transplant survival (Table). Male gender, heart disease, and an unweighted and modified CCI scores were significantly greater among patients surviving <3 years post-transplant. Multivariable analysis identified the unweighted CCI (OR= 1.47, CI: 1.02-2.13) and modified CCI (OR= 1.35, CI: 1.08-1.69) as significant predictors of 3-year mortality, but not age, gender or time on waitlist. However, after adjusting for age and gender, only the modified CCI was predictive (OR= 1.30, CI: 1.03-1.64).

Conclusion

A modified CCI is a simple and effective tool for predicting 3-year mortality following transplantation in elderly patients. This scoring system should be considered as an adjunct in determining transplant candidacy in this population.