Live and Deceased Donor Kidney Transplantation in Patients Aged 75 years and Older in the United States

Macrae, Jeanne; Friedman, Amy L.; Friedman, Eli A.; Eggers, Paul W.

doi:10.1007/s11255-004-0010-6

Cited by 63 publications

(31 citation statements)

References 14 publications

(11 reference statements)

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“…This suggests that kidney transplantation offers a significant reduction in long-term mortality compared with dialysis in elderly patients with renal failure on the transplantation waiting list. This is further supported by another study by Macrae et al, who analyzed data from the United States Renal Data System Standard Analysis Files [44]. All persons aged 75 and over who received a kidney transplant from 1994 to 2000 were compared with those remaining on dialysis or on a transplant waiting list.…”

Section: Impact Of Recipient Age On Transplant Outcomesmentioning

confidence: 86%

Renal transplantation in the elderly

Saxena

Yu²,

Giraldo

et al. 2008

Int Urol Nephrol

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Elderly patients are increasingly being considered for kidney transplantation due to a global explosion of the aging population with end-stage renal disease (ESRD). However, mounting scarcity of available organs for transplant has led to a wider disparity between organ supply and demand. Consequently, the criteria for accepting kidneys for transplantation have been extended in an attempt to allow the use of organs from elderly donors or those with significant co-morbidities, so-called "expanded criteria donor" (ECD) kidneys. Excellent outcomes have been achieved from ECD kidneys with appropriate donor and recipient profiling and selection. With increasing recovery efforts directed at older donors, the concept of age-matching is becoming more accepted as a method of optimizing utilization of organs in elderly donors and recipients. Utilization of pulsatile perfusion has further improved ECD outcomes and helped the decision-making process for the UNOS (United Network for Organ Sharing) offer. However, age-related immune dysfunction and associated co-morbidities make the elderly transplant recipients ever more susceptible to complications associated with immunosuppressive agents. Consequently, the elderly population is at a higher risk to develop infections and malignancy in the post-transplant period notwithstanding improved transplant outcomes. Appropriate immunosuppressive agents and dosages should be selected to minimize adverse events while reducing the risk of acute rejections and maximizing patient and renal allograft survival.

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Section: Impact Of Recipient Age On Transplant Outcomesmentioning

confidence: 86%

Renal transplantation in the elderly

Saxena

Yu²,

Giraldo

et al. 2008

Int Urol Nephrol

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“…Kidney transplantation is the preferred treatment modality for patients with stage 5 chronic disease (CKD) or end-stage renal disease (ESRD), because it offers a longer life span, superior quality of life and lower economic costs for the society compared to long-term dialysis [1][2][3][4][5]. The number of patients with ESRD increased dramatically over the last 2 decades, and the increasing demand for transplantable donor kidneys has been highly exceeding the available supply [6].…”

Section: Introductionmentioning

confidence: 99%

Non-medical factors influencing access to renal transplantation

2009

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Considering the scarcity of available donor kidneys and the increasing number of patients with end-stage renal disease (ESRD) who would potentially benefit from renal transplantation, objective and equitable patient selection and equitable access to renal transplantation bear substantial importance. Inequalities in access to renal transplantation have been extensively documented over the last 2 decades with regard to age, gender, ethnicity, socioeconomic and psycho-social factors. In this paper we review a wide spectrum of social, patient and system-related factors along the transplantation process that may be associated with disparities, and we aim to describe the complex interrelationship between these factors that might influence treatment decisions by patients and health-care professionals. Understanding potentially modifiable barriers to kidney transplantation may allow designing targeted interventions in order to guarantee fair recipient selection and equal access to renal transplantation.

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“…Chronological age, in itself, is not a barrier to transplantation, and there is currently no age limit for access to transplantation in the United States. Moreover, a recent study showed that a survival benefit of transplant is observed in carefully selected individuals older than 75 yr of age (7). With the aging of the American population, further growth in the population of elderly patients with ESRD is anticipated.…”

mentioning

confidence: 99%