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논문분류	춘계학술대회 초록집
제목	Comparisons of Clinical Outcomes between Kidney Transplant Recipients and Hemodialysis Patients in the Elderly: A Propensity Score-Matched Analysis
저자	Yu Ho Lee
출판정보	2026; 2026(1):
키워드	kidney transplantation, elderly, all-cause mortality, cardiovascular events
초록	Objectives: Kidney transplantation (KT) in elderly patients remains controversial due to concerns regarding post-transplant complications and limited comparative data with non-transplant populations. This study aimed to compare clinical outcomes between elderly KT recipients and elderly hemodialysis patients using a nationwide registry-based cohort. Methods: Elderly patients aged ≥65 years were identified from the Korean Network for Organ Sharing (KONOS) database. KT recipients were compared with hemodialysis patients who were listed for kidney transplantation. Propensity score matching was performed to minimize baseline differences. The primary outcomes were all-cause mortality, cardiovascular events, infection requiring hospitalization, and cancer development. Results: After propensity score matching, 797 elderly KT recipients and 2,028 matched hemodialysis patients were included. KT recipients were male predominant and had shorter duration of dialysis compared to hemodialysis patients. Elderly KT recipients showed significantly lower risks of all-cause mortality and cardiovascular events compared with hemodialysis patients (adjusted hazard ratio [HR] = 0.61, 95% confidence interval [CI] = 0.49 – 0.76 and adjusted HR = 0.57, 95% CI = 0.43 – 0.76, respectively). In contrast, the risk of infection requiring hospitalization was higher in KT recipients, particularly during the early post-transplant period, but gradually stabilized over time (adjusted HR = 1.26, 95% CI = 1.09 – 1.45). The risk of cancer did not differ significantly between the two groups. Conclusion: In elderly patients with end-stage kidney disease, KT was associated with improved survival and cardiovascular outcomes compared with hemodialysis, despite a higher early risk of infection-related hospitalization. These findings support KT as a viable treatment option for selected elderly patients, emphasizing the need for careful infection monitoring, especially in the early post-transplant period.
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