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Renal transplantation in the elderly.

J S Cameron1

  • 1Department of Nephrology and Transplantation, Guy's and St Thomas' Hospitals, King's College, London, United Kingdom. jstewart_cameron@email.msn.com

International Urology and Nephrology
|March 7, 2001
PubMed
Summary

Kidney transplantation is medically appropriate for elderly patients (under 70-75), offering better survival and quality of life than dialysis. Outcomes are comparable to younger recipients, despite higher risks of death from other causes.

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Area of Science:

  • Nephrology
  • Geriatric Medicine
  • Transplantation Surgery

Background:

  • Historically, elderly patients with end-stage renal failure have been underrepresented in kidney transplantation programs.
  • Concerns regarding medical and ethical considerations have limited transplantation in older populations.

Purpose of the Study:

  • To evaluate the medical and ethical feasibility of kidney transplantation in elderly patients.
  • To compare outcomes of kidney transplantation in elderly versus younger recipients.

Main Methods:

  • Analysis of recent data on kidney transplantation outcomes in elderly patients (≥70 or ≥75 years).
  • Comparison of graft survival, patient survival, and quality of life between elderly and younger transplant recipients.
  • Evaluation of donor-recipient age matching and the role of living donors.

Main Results:

  • Kidney transplantation is medically and ethically justifiable for elderly patients (under 70-75 years).
  • Elderly recipients exhibit comparable graft survival to younger recipients, attributed to lower rejection rates.
  • Patient survival is improved, quality of life enhanced, and treatment costs reduced compared to dialysis in the elderly.
  • Age-matching kidneys to older recipients is not supported; younger donor organs yield better results.
  • Living donor kidney transplantation is successful in recipients over 70, including elderly living donors.

Conclusions:

  • Kidney transplantation offers significant benefits for carefully selected elderly patients.
  • Challenges in organ allocation and determining optimal immunosuppression for elderly recipients require further investigation.
  • The study supports expanding kidney transplantation to the elderly population, challenging previous limitations.

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