Rates of renal transplantations in the elderly—data from Europe and the US

Sørensen, Søren Schwartz

doi:10.1016/j.trre.2015.04.005

Cited by 24 publications

(18 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Given the emerging evidence of the benefits of KT on survival in the elderly ESRD population, the age of patients on the WL for KT has risen significantly over the last decades worldwide [3, 4, 18-21]. However, previous reports have documented that approximately half of elderly KT candidates (>60 years) in the United States die on the WL before receiving a deceased-donor transplant [22].…”

Section: Risks Of Death On the Waiting-listmentioning

confidence: 99%

“…>65 years) are less frequently placed on the waiting list (WL), due to uremia-related life-threatening comorbidities, and, if they are listed, they have fewer chances of receiving a KT than their younger counterparts, partly owing to emergent events (cardiovascular disorders, infections, neoplasias, etc.) that can modify their transplant status whilst on the WL [3, 4]. In addition, assessment of elderly KT candidates is complex and evidence-based clinical guidelines for the management of this particular population are lacking [4-8].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, assessment of elderly KT candidates is complex and evidence-based clinical guidelines for the management of this particular population are lacking [4-8]. Moreover, many transplant teams are still reluctant to include elderly patients on the WL for KT as objective selection criteria for transplantation in this population are poorly defined [3, 4, 9]. Misconceptions regarding the inclusion criteria for elderly patients for KT could delay early referral to a transplant center or delay WL inclusion, leading to a longer time spent on dialysis.…”

Section: Introductionmentioning

confidence: 99%

“…Although many studies have demonstrated that KT is relatively safe and provides a better survival compared with age-matched dialysis patients [10-14], the benefits in survival could be tapered by risk in elderly patients, especially in those who have spent a prolonged time on the WL [3, 15-17]. Indeed, elderly KT recipients also have an increased risk of cardiovascular (CV) diseases, infections and neoplastic events, leading to higher post-transplant mortality than younger patients.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Mortality in Elderly Waiting-List Patients Versus Age-Matched Kidney Transplant Recipients: Where is the Risk?

Hernández

Alonso-Titos

Armas-Padrón³

et al. 2018

Kidney Blood Press Res

View full text Add to dashboard Cite

The number of elderly patients on the waiting list (WL) for kidney transplantation (KT) has risen significantly in recent years. Because KT offers a better survival than dialysis therapy, even in the elderly, candidates for KT should be selected carefully, particularly in older waitlisted patients. Identification of risk factors for death in WL patients and prediction of both perioperative risk and long-term post-transplant mortality are crucial for the proper allocation of organs and the clinical management of these patients in order to decrease mortality, both while on the WL and after KT. In this review, we examine the clinical results in studies concerning: a) risk factors for mortality in WL patients and KT recipients; 2) the benefits and risks of performing KT in the elderly, comparing survival between patients on the WL and KT recipients; and 3) clinical tools that should be used to assess the perioperative risk of mortality and predict long-term post-transplant survival. The acknowledgment of these concerns could contribute to better management of high-risk patients and prophylactic interventions to prolong survival in this particular population, provided a higher mortality is assumed.

show abstract

Section: Risks Of Death On the Waiting-listmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Mortality in Elderly Waiting-List Patients Versus Age-Matched Kidney Transplant Recipients: Where is the Risk?

Hernández

Alonso-Titos

Armas-Padrón³

et al. 2018

Kidney Blood Press Res

View full text Add to dashboard Cite

show abstract

“…5 Furthermore, in the context of donor shortage, the probability for waitlisted elderly patients of actually receiving a kidney transplant is still lower than that for younger counterparts. 6 Nevertheless, another important reason for this lower transplant rate in the elderly may be that incurring events (eg, infections or cardiovascular complications) might alter their transplant status, at least temporarily.…”

mentioning

confidence: 99%

Criteria for and Appropriateness of Renal Transplantation in Elderly Patients With End-Stage Renal Disease

et al. 2016

View full text Add to dashboard Cite

During the last 20 years, waiting lists for renal transplantation (RT) have grown significantly older. However, elderly patients (ie ≥65 years of age) are still more rarely referred or accepted to waiting lists and, if enlisted, have less chances of actually receiving a kidney allograft, than younger counterparts. In this review, we looked at evidence for the benefits and risks of RT in the elderly trying to answer the following questions: Should RT be advocated for elderly patients? What should be the criteria to accept elderly patients on the waiting list for RT? What strategies might be used to increase the rate of RT in waitlisted elderly candidates? For selected elderly patients, RT was shown to be superior to dialysis in terms of patient survival. Virtually all guidelines recommend that patients should not be deemed ineligible for RT based on age alone, although a short life expectancy generally might preclude RT. Concerning the assessment of comorbidities in the elderly, special attention should be paid to cardiac evaluation and screening for malignancy. Comorbidity scores and frailty assessment scales might help the decision making on eligibility. Psychosocial issues should also be evaluated. To overcome the scarcity of organ donors, elderly RT candidates should be encouraged to consider expanded criteria donors and living donors, as alternatives to deceased standard criteria donors. It has been demonstrated that expanded criteria donor RT in patients 60 years or older is associated with higher survival rates than remaining on dialysis, whereas living donor RT is superior to all other options.

show abstract

Renal Transplantation in the Elderly

Diflo

2020

Surgical Decision Making in Geriatrics

View full text Add to dashboard Cite

Rates of renal transplantations in the elderly—data from Europe and the US

Cited by 24 publications

References 3 publications

Mortality in Elderly Waiting-List Patients Versus Age-Matched Kidney Transplant Recipients: Where is the Risk?

Mortality in Elderly Waiting-List Patients Versus Age-Matched Kidney Transplant Recipients: Where is the Risk?

Criteria for and Appropriateness of Renal Transplantation in Elderly Patients With End-Stage Renal Disease

Renal Transplantation in the Elderly

Contact Info

Product

Resources

About