AI Article Synopsis
- - Older adults represent a growing segment of the kidney transplant waitlist, but they face higher mortality rates and lower graft survival compared to younger recipients.
- - Clinicians must weigh the risks of transplant procedures against the potential benefits of survival compared to dialysis, taking factors like age, frailty, and organ availability into consideration.
- - Targeted strategies, including quicker evaluations and better use of available organs, can enhance transplant access for older patients, alongside educational efforts to improve care outcomes.
Article Abstract
Purpose Of Review: To summarize the current state of evidence related to the outcomes of older adults who need and receive kidney transplants, and strategies to facilitate appropriate transplant access in this at-risk group.
Recent Findings: Older adults are a rapidly growing subgroup of the kidney transplant waitlist. Compared to younger adults, older kidney transplant recipients have increased mortality after kidney transplant and lower death-censored graft survival. In determining suitability for transplantation in older patients, clinicians must balance procedural and immunosuppression-related risk with incremental survival when compared with dialysis. To appropriately increase access to transplantation in this population, clinicians and policy makers consider candidates' chronological age and frailty, as well as the quality of and waiting time for a donated allograft. Given risk of deterioration prior to transplant, candidates should be rapidly evaluated, listed, and transplanted using living donor and or less than ideal deceased donor organs when available.
Summary: Access to transplantation for older adults can be increased through targeted interventions to address frailty and reduce waiting times through optimized organ use. Focused study and educational interventions for patients and providers are needed to improve the outcomes of this vulnerable group.
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| http://dx.doi.org/10.1097/MNH.0000000000000871 | DOI Listing |
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