Seminars in Nephrology
Volume 29, Issue 6 , Pages 621-635, November 2009

Kidney Transplantation in the Elderly

  • Edmund Huang, MD

      Affiliations

    • Department of Medicine, Johns Hopkins University, Baltimore, MD
    • ,
  • Dorry L. Segev, MD

      Affiliations

    • Department of Surgery, Johns Hopkins University, Baltimore, MD
    • ,
  • Hamid Rabb, MD

      Affiliations

    • Department of Medicine, Johns Hopkins University, Baltimore, MD
    • Corresponding Author InformationAddress reprint requests to Hamid Rabb, MD, Department of Medicine, Ross 965, Johns Hopkins Hospital, 720 Rutland Ave, Baltimore, MD 21205

Summary 

There is an increase in the older incident end-stage renal disease population that is associated with an increasing prevalence of end-stage renal disease in the United States. This trend is paralleled by an increasing rate of kidney transplantation in the elderly. Although patient survival is lower in older versus younger kidney recipients, the elderly benefit from a reduction in mortality rate and improved quality of life with transplantation compared with dialysis. Immunologic, physiologic, and psychosocial factors influence transplant outcomes and should be recognized in the care of the elderly transplant patient. In this review, we discuss transplantation in the elderly patient, particularly the topics of access to transplantation, patient and graft survival, the impact of donor quality on transplant outcomes, immunology and immunosuppression of aging, and ethical considerations in the development of an equitable organ allocation scheme.

Keywords: Elderly, kidney transplant, aging, patient survival, graft survival

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PII: S0270-9295(09)00150-8

doi:10.1016/j.semnephrol.2009.07.011

Seminars in Nephrology
Volume 29, Issue 6 , Pages 621-635, November 2009

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