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Geriatric Nephrology and Urology

, Volume 1, Issue 2, pp 105–112 | Cite as

Kidney transplantation in the elderly

  • James A. Schulak
  • Donald E. Hricik
Article
  • 21 Downloads

Abstract

The outcome of renal transplantation in older patients has been improving steadily over the past decade such that advanced age alone is no longer an independent contraindication to this procedure. Review of this center's experience with kidney transplantation in patients older than 60 yr of age revealed an overall 1 year patient and graft survival of 82%. Low risk patients, defined as those without diabetes or cardiovascular disease, had markedly improved patient (91%) and graft (84%) survival rates. Review of the literature revealed 1 year patient and graft survivals of 60–77% and 48–74% respectively for patients transplanted in the pre-cyclosporine era. Under cyclosporine immunosuppression, kidney transplant outcomes were generally improved with patient and graft survival ranges of 79–97% and 67–93%, respectively. Although medical complications such as myocardial infarction, pneumonia; and steroid induced diabetes are more frequent in the elderly, irreversible allograft rejection appears to occur less frequently than in younger patients. Consequently, rigorous pretransplant screening for comorbidity is very important and posttransplant strategies of reduced immunosuppression may be prudent. With increasing numbers of older patients awaiting kidney transplantation, advanced age is now being reevaluated as a contraindication to kidney donation.

Key words

Age kidney transplant recipient kidney tranplantation elderly kidney donors elderly 

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Copyright information

© Kluwer Academic Publishers 1991

Authors and Affiliations

  • James A. Schulak
    • 1
  • Donald E. Hricik
    • 1
  1. 1.Transplantation ServiceUniversity Hospitals of Cleveland and the Departments of Surgery and Medicine, Case Western Reserve UniversityCleveland

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