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Need for optimized immunosuppression in elderly kidney transplant recipients
L J Lehner1, Oliver Staeck1, Fabian Halleck1
1Department of Nephrology, Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany on behalf of the DESCARTES - ERA-EDTA/EKITA working group.
Transplantation Reviews (Orlando, Fla.)
|September 29, 2015
Summary
Elderly kidney transplant recipients need tailored immunosuppression. Research suggests reducing immunosuppression after initial graft adaptation may lower risks like cancer and infection in seniors.
Area of Science:
- Nephrology
- Immunology
- Geriatrics
Background:
- The proportion of elderly kidney transplant candidates is increasing globally.
- Organ allocation policies are adapting, with programs like the European Senior Program matching elderly donors to elderly recipients.
- Age-related immune changes and increased susceptibility to side effects necessitate tailored immunosuppressive strategies for older adults.
Purpose of the Study:
- To investigate the need for re-evaluation of standard immunosuppressive therapy in elderly kidney transplant recipients.
- To explore the potential benefits of modified immunosuppression in this growing patient population.
Main Methods:
- Review of current evidence and clinical trial data concerning immunosuppression in elderly kidney transplant recipients.
- Analysis of age-dependent immune responses and side effect profiles.
Main Results:
- Standard immunosuppressive therapy guidelines were primarily based on younger populations, with elderly patients often excluded.
- Elderly patients are susceptible to graft rejection, particularly with poorly matched organs.
- Rejection therapies can lead to detrimental side effects, including over-immunosuppression (cancer, infections) and cardiovascular issues.
Conclusions:
- Novel treatment strategies and robust prospective clinical trials are essential.
- Time-adapted immunosuppressive regimens tailored to the unique needs of elderly kidney transplant recipients must be established.
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