Impact of Advanced Age on Posttransplant Infections and Outcomes in Solid Organ Transplant Recipients: A Multicenter Cohort Study

BACKGROUND: In recent years, with the aging population worldwide, the number of elderly undergoing solid organ transplantation has been steadily increasing. However, data on the effects of advanced age on infection characteristics and clinical outcomes in transplant recipients are limited. This study aimed to evaluate the effects of advanced age on infections and clinical outcomes in solid organ transplant recipients. METHODS: This retrospective multicenter cohort study included patients who underwent solid organ transplantation at different transplant centers in Türkiye between 2003 and 2023 and were followed up for at least 1 year. Patients were divided into two age groups: ≥ 60 years and < 60 years. Demographic characteristics, laboratory parameters, infection episodes, and clinical outcomes were compared between the two age groups. RESULTS: The study included 273 (27.7%) patients aged ≥ 60 years and 712 (72.3%) patients aged < 60 years, totaling 985 recipients. Male sex and liver transplantation were more common in the older age group (p < 0.001). Hospital stay was significantly longer in patients aged ≥ 60 years (p = 0.002). However, there was no difference between the two age groups in terms of time to first infection or number of infection episodes. The mortality rate in patients aged ≥ 60 years was 21.6%. The most common cause of death was bacterial infection, with carbapenem-resistant pathogens detected in a substantial proportion of cases. CONCLUSIONS: Although infection incidence was similar across age groups, solid organ transplant recipients aged ≥ 60 years had higher mortality and longer hospital stays, highlighting the need for careful clinical monitoring in older transplant recipients.