Quality of Life in Elderly Kidney Transplant Recipients

Weber, Marc; Faravardeh, Arman; Jackson, Scott; Berglund, Danielle; Spong, Richard; Matas, Arthur J.; Gross, Cynthia R.; Ibrahim, Hassan N.

doi:10.1111/jgs.13065

Cited by 37 publications

(50 citation statements)

References 14 publications

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“…Age may have an effect on post-transplant QOL[35-37]. In a single center study by Weber et al[36], they compared the post-transplant health-related QOL of patients ≥ 65 years with younger patients and with the general population. They found that physical QOL in older patients was significantly lower compared to younger patients and the general population.…”

Section: What Outcomes Can Be Expected Post-transplant?mentioning

confidence: 99%

Older candidates for kidney transplantation: Who to refer and what to expect?

Concepcion¹,

Forbes²,

Schaefer³

2016

WJT

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The number of older end-stage renal disease patients being referred for kidney transplantation continues to increase. This rise is occurring alongside the continually increasing prevalence of older end-stage renal disease patients. Although older kidney transplant recipients have decreased patient and graft survival compared to younger patients, transplantation in this patient population is pursued due to the survival advantage that it confers over remaining on the deceased donor waiting list. The upper limit of age and the extent of comorbidity and frailty at which transplantation ceases to be advantageous is not known. Transplant physicians are therefore faced with the challenge of determining who among older patients are appropriate candidates for kidney transplantation. This is usually achieved by means of an organ systems-based medical evaluation with particular focus given to cardiovascular health. More recently, global measures of health such as functional status and frailty are increasingly being recognized as potential tools in risk stratifying kidney transplant candidates. For those candidates who are deemed eligible, living donor transplantation should be pursued. This may mean accepting a kidney from an older living donor. In the absence of any living donor, the choice to accept lesser quality kidneys should be made while taking into account the organ shortage and expected waiting times on the deceased donor list. Appropriate counseling of patients should be a cornerstone in the evaluation process and includes a discussion regarding expected outcomes, expected waiting times in the setting of the new Kidney Allocation System, benefits of living donor transplantation and the acceptance of lesser quality kidneys.

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Section: What Outcomes Can Be Expected Post-transplant?mentioning

confidence: 99%

Older candidates for kidney transplantation: Who to refer and what to expect?

Concepcion¹,

Forbes²,

Schaefer³

2016

WJT

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show abstract

“…The mental component summary QOL scores of elderly adults with ESRD, indirectly measuring mental health and social and emotional functioning, tended to be higher than the physical component summary QOL scores, which indirectly measure physical functioning and presence of physical symptoms. Physical component summary QOL scores in elderly adults were much lower than in younger individuals in all four studies in which this was explored . This was most pronounced in adults with ESRD aged 80 and older.…”

Section: Resultsmentioning

confidence: 82%

“…Nevertheless, the limited data from the studies on QOL in these elderly adults are promising, with 47% (8/17) showing overall HRQOL and mental component summary QOL scores in elderly adults with ESRD similar to or higher than those of age‐matched controls or younger individuals . This supports the opinion that older adults should not be excluded from RRT based solely on age and suggests that RRT can be clinically appropriate and worthwhile in these individuals.…”

Section: Discussionmentioning

confidence: 77%

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Quality of Life, Perceptions, and Health Satisfaction of Older Adults with End‐Stage Renal Disease: A Systematic Review

Balogun

Philbrick

et al. 2016

J American Geriatrics Society

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Few studies specifically examine QOL in elderly adults with ESRD undergoing RRT and even fewer address issues of perceptions and health satisfaction. However, the limited data from the QOL studies looks promising with a significant proportion showing similar or higher overall health-related and mental component summary QOL scores in elderly adults with ESRD. The very limited data on perceptions and health satisfaction of elderly adults with ESRD undergoing RRT makes it difficult to make any generalizable conclusions. Overall, more research is needed to examine these factors in elderly adults with ESRD.

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“…Over the past decade, kidney graft survival has increased and overall mortality has decreased substantially in older transplant recipients, even in those aged 80 and older . Furthermore, quality of life in older adults after kidney transplantation has been shown to be better than in younger transplant recipients and equal to that of the general population . Nevertheless, older age has been a deterrent to access to the deceased donor waiting list, and older adults have a lower probability of being referred and listed for kidney transplant, even in the absence of an absolute contraindication, than younger adults.…”

mentioning

confidence: 99%

The Evolution of Living Kidney Donation and Transplantation in Older Adults

Rowe

Huded

McElroy

et al. 2015

J American Geriatrics Society

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Kidney transplantation is a good option for adults aged 65 and older with end-stage renal disease because it has been shown to reduce morbidity and mortality, improve quality of life, and is more cost-effective than other renal replacement options. However, older age has been a deterrent to access to the deceased donor waiting list, and individuals aged 65 and older have a lower probability of being referred to and listed for transplantation compared to younger adults. Because the deceased organ supply is limited, living donor kidney transplantation offers an effective alternative for older adults facing long waiting times for cadaveric organs. This article describes the evolution of living kidney donation and transplantation in older adults over 15 years using the Organ Procurement and Transplantation Network/Scientific Registry of Transplant Recipients database. Between 1997 and 2011, 28,034 kidney transplantations were performed in adults aged 65 and older. Living-donor and cadaveric kidney transplantation increased in older adults over the 15-year period. Offspring are the most common living donors in this age group, followed by unrelated donors (e.g., friends), whereas the most common donors in younger transplant recipients are spouses, siblings, and parents. The number of living kidney donors aged 65 and older is slowly increasing, although the total number of transplants in this age group remains low. The expansion of living-donor kidney transplantation in the aging population may offer a solution for organ shortage and thereby improve the quality of life of older adults. More research is needed to understand the older donor-recipient relationship and barriers to transplantation in this population.

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Quality of Life in Elderly Kidney Transplant Recipients

Abstract: Physical QOL is lower in elderly recipients but mental QOL is maintained and is higher than in younger recipients.

Cited by 37 publications

References 14 publications

Older candidates for kidney transplantation: Who to refer and what to expect?

Older candidates for kidney transplantation: Who to refer and what to expect?

Quality of Life, Perceptions, and Health Satisfaction of Older Adults with End‐Stage Renal Disease: A Systematic Review

The Evolution of Living Kidney Donation and Transplantation in Older Adults

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