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[Kidney transplantation in aged patients]
1Service Néphrologie, immunologie clinique, CHU Hôtel-Dieu 44093 Nantes. mav@hotmail.fr
La Revue Du Praticien
|March 8, 2006
Summary
Kidney transplantation for elderly patients has surged, showing better survival than dialysis. Age alone shouldn't prevent transplantation, necessitating expanded donor criteria due to organ shortages.
Area of Science:
- Nephrology
- Geriatric Medicine
- Transplantation Surgery
Context:
- The number of elderly patients (> 65 years) on kidney transplant waiting lists and receiving transplants has increased fivefold between 1990 and 2004.
- Transplantation in individuals over 70 years old is now common.
- Elderly recipients often receive marginal organs from older donors with cardiovascular issues.
Purpose:
- To evaluate the outcomes of kidney transplantation in elderly patients.
- To determine if patient age should be a contraindication for kidney transplantation.
- To explore strategies for increasing transplantable organ sources.
Summary:
- Graft survival in elderly patients is lower than in younger patients, but this disparity vanishes when patient deaths are censored.
- Patient survival post-transplantation is significantly superior to remaining on dialysis.
- The findings suggest that advanced age should not preclude kidney transplantation.
Impact:
- Highlights the improved patient survival with kidney transplantation compared to dialysis in the elderly.
- Emphasizes the need to reconsider donor acceptance criteria to address organ shortages.
- Supports the expansion of donor pools to include organs from donors with expanded criteria for elderly recipients.