Clinical Outcomes and Quality of Life in Older De Novo Kidney Transplant Recipients Under Once-Daily Tacrolimus Formulations: The BITACORA Study
Por:
Andrés, A, Jiménez, S, Regidor, MJA, Moreso, F, Crespo, M, Cabañas, NS, Gómez, G, López, V, Corte, MDCD, Fraile-Gómez, P, Lorenzo, I, San Millán, JCR, Cañas, L, Benot, AR, Romero, NC, Diekmann, F, Mendiluce, A, Rivera, CF, Gallego, R, Jiménez, C, Martin-Moreno, PL, Tagarro, EF, Díaz, C, Urcuyo, BM, Roncero, FMG
Publicada:
7 mar 2026
Resumen:
Introduction Although advanced age is no longer a contraindication for renal transplantation, real-world data on elderly transplant recipients remain limited. Methods This multicenter, prospective study enrolled de novo kidney transplant recipients aged 60 years or older receiving once-daily tacrolimus immunosuppression, following recovery of renal function and referral to the transplant clinic. The primary objective was to describe clinical characteristics and post-transplant outcomes over a 12-month follow-up. Secondary objectives included assessing changes in quality of life and the relationship between biopsy-proven acute rejection (BPAR) and tacrolimus levels. Results Of 280 evaluable patients, 239 completed the 12-month follow-up (mean recipient age: 69.8 years; mean donor age: 69.1 years) and 41 (14.6%) terminated due to graft loss (13, 31.7%), tacrolimus termination (12, 29.3%), death (10, 24.4%), loss to follow-up (3, 7.3%), other (2, 4.9%), and temporary tacrolimus interruption (1, 2.4%). BPAR occurred in 8.2% of patients who showed significantly higher tacrolimus levels vs those without BPAR over the follow-up (9.8 ng/mL vs. 8.9 ng/mL; p = 0.01). Opportunistic infections were reported in 78.3% patients with BPAR vs 58.8% without BPAR (p = 0.07). Quality of life improved across different domains of the Kidney Transplant Questionnaire and the ESRD-SCL. Conclusion This study monitored clinical outcomes during the first year post-transplant in older de novo kidney transplant recipients receiving grafts from older donors and under a once-daily tacrolimus-based immunosuppressive regimen. The incidence of BPAR, graft loss, and mortality was low, and patients generally experienced an improvement in quality of life, indicating an effective and safe procedure in this population.
Filiaciones:
Andrés, A:
Hosp Univ 12 Octubre, Nephrol Dept, Madrid, Spain
Jiménez, S:
Hosp Univ Ramon & Cajal, Nephrol Dept, Madrid, Spain
Univ Alcala de Henares, Madrid, Spain
Regidor, MJA:
Hosp Univ Miguel Servet, Nephrol Dept, Zaragoza, Spain
Moreso, F:
Hosp Univ Vall dHebron, Dept Nephrol, Barcelona, Spain
Autonomous Univ Barcelona, Barcelona, Spain
Crespo, M:
Hosp del Mar, Nephrol Dept, Barcelona, Spain
Univ Pompeu Fabra, Barcelona, Spain
Cabañas, NS:
Fundacio Puigvert, Dept Nephrol, Barcelona, Spain
Gómez, G:
Hosp Univ Son Espases, Nephrol Dept, Palma Illes Balears, Spain
López, V:
Univ Malaga, Reg Univ Hosp Malaga, Malaga Biomed Res Inst IBIMA BIONAND Platform, Nephrol Dept, Malaga, Spain
Corte, MDCD:
Univ Oviedo, Hosp Univ Cent Asturias Translat Immunol, Hlth Res Inst Principal Asturias ISPA, Nephrol Dept, Oviedo, Asturias, Spain
Fraile-Gómez, P:
Complejo Asistencial Univ Salamanca, Nephrol Dept, Salamanca, Spain
Lorenzo, I:
Hosp Albacete, Nephrol Dept, Albacete, Spain
San Millán, JCR:
Marques de Valdecilla Univ Hosp, Immunol Dept, Immunopathol Grp, IDIVAL, Santander, Spain
Cañas, L:
Univ Hosp Germans Trials i Pujols, Nephrol Dept, Badalona, Barcelona, Spain
Benot, AR:
Univ Hosp Reina Sofia, Renal Unit, Dept Nephrol, Cordoba, Spain
Romero, NC:
Hosp Clin San Carlos, Nephrol Dept, Madrid, Spain
Diekmann, F:
Inst Salud Carlos III, Nephrol Dept, Lab Expt Nefrol & Trasplantament LENIT, IDIBAPS,Hosp Clin Barcelona, Madrid, Spain
Mendiluce, A:
Hosp Clin Univ Valladolid, Nephrol Dept, Valladolid, Spain
Rivera, CF:
Complexo Hosp Univ Coruna, Nephrol Dept, La Coruna, Spain
Gallego, R:
Hosp Dr Negrin, Nephrol Dept, Las Palmas Gran Canaria, Spain
Jiménez, C:
Hosp Univ La Paz, IdiPAZ, Dept Nephrol, Madrid, Spain
Martin-Moreno, PL:
Clin Univ Navarra, Navarra Inst Hlth Res, Nephrol Dept, IdiSNA, Pamplona, Spain
Tagarro, EF:
Complejo Hosp Univ Insular Materno Infantil Gran C, Nephrol Dept, Gran Canaria, Spain
Díaz, C:
Hosp Santiago de Compostela, Nephrol Dept, Santiago De Compostela, Spain
Urcuyo, BM:
Hosp Univ Doctor Jose Molina Orosa, Nephrol Dept, Lanzarote, Spain
Roncero, FMG:
Hosp Univ Virgen Rocio, UroNephrol Dept, Renal Transplant Unit, Seville, Spain
Green Submitted, hybrid
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