Between 2000 and 2021, the Hospital Clínic performed 2,622 kidney transplants. During that period, 88 transplants were carried out in patients 75 years old or older (82 from deceased donors and 6 from living donors). Of these 88 transplant recipients, 15 were 80 years old or older. According to data from the Catalan Transplant Organization (Organització Catalana de Trasplantament, OCATT), the percentage of kidney transplants in people over 74 years old in Catalonia has increased from 2.4% to 10% in the last 10 years. This shows an upward trend in kidney transplantation in older people and reinforces the idea that age in itself should not be an absolute contraindication for transplantation. Kidney transplantation is a safe procedure that offers advantages over survival on dialysis in most patients. However, in older patients, the risk/benefit ratio must be assessed on an individual basis, given that it can lead to medical, socioeconomic and ethical problems.
The patient, 90 years old, had chronic kidney disease, was on a haemodialysis programme and had been on a waiting list for four years. A few weeks after the surgery was performed, the patient felt well, in the recovery phase, and had a better quality of life than before the operation. At present, the patient’s post-operative follow-up is being carried out by Dr. Vicenç Torregrosa, a nephrologist at the hospital.
According to Dr. Antonio Alcaraz, “the complexity of performing a transplant of these characteristics is an exceptional event that shows the great human and technical skills at the Clínic, with the aim of personalizing treatments and improving the quality of life of patients with chronic kidney disease”.
Dr. Fritz Diekmann, head of the Kidney Transplant Section, is very sure that “today there are no age barriers when it comes to kidney donation and transplants. So, the possibility of transplantation depends far more on an individual's biological age than their chronological age. The improvement in the transplanted patient’s quality of life is huge, despite his advanced age”.
90-year-old Agustí Rovira’s transplant
Agustí Rovira is 90 years old and underwent a kidney transplant at the Hospital Clínic de Barcelona. Before the transplant, he had a very active life and loved travelling. Gradually, he began to notice that he felt more tired, and at the check-ups with the urology team he was alerted to the fact that he had small kidney cysts, which initially should not have caused any serious complications. However, as the years passed, these kidney problems continued, and he started to have dialysis sessions. This went on for 5 years and 3 months. When he came out of the dialysis sessions, he was very tired, but the following day he would “perk up a little", he explains.
When he had been having dialysis for some time, the Hospital Clínic nephrology team decided to put him on the waiting list. Agustí says, “I never lost hope that one day I would be able to have a kidney transplant”. And that day came. Dr. Mireia Musquera, the urologist who operated on him, phoned him first thing in the afternoon and told him the time had come and that he could “go to the hospital straight away”, Agustí recounts with emotion.
Now, Agustí is recuperating from the operation and is already thinking about being able to lead a normal life and, if he can, taking a plane. “I face life without thinking about the expiry date. I haven’t lost my curiosity and I don’t go to sleep if I have any historical or linguistic doubts... I don’t want to leave anything unfinished”, he explains. “We don’t know whether this transplant has lengthened my life, but what I can say is that it has given me quality of life”, he concludes.
The kidney transplant:
A kidney transplant consists of implanting a kidney from a deceased or a living donor into a person who has advanced chronic kidney disease in order to replace the function of the diseased kidneys.
The objective of the transplant is to re-establish the functions of the kidney, which include cleansing toxins from the blood, regulating the fluid and electrolyte balance (balance between the amount of water and minerals), synthesizing various hormones, and thus avoiding the need for dialysis.
Last year, the Hospital Clínic performed 156 kidney transplants. In 2022, the figure is expected to reach around 200 by the end of the year.