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Kidney Transplant in Elderly

  • Lucas Petraglia
  • Kristian HeldalEmail author
Chapter

Abstract

Kidney transplant in the elderly has its own characteristics, such as the increasing proportion of elderly recipients, extended criteria for donor allocation, better survival rates compared to their dialysis counterparts, higher prevalence of frailty, lower prescription adherence, particular immunosuppressant protocols, as well as high incidence of death with a functioning organ due to cardiovascular disease, infection, or malignancy. In summary, kidney transplantation is an attractive treatment option for end-stage renal disease patients that after a standard medical evaluation are found eligible.

Keywords

Kidney transplantation Elderly Immunosuppressant 

References

  1. 1.
    2015 USRDS Annual Data Report [Internet]. [Cited 2018 Sep 29]. Report no.: volume 2 – ESRD in the United States. Chapter 1: incidence, prevalence, patient characteristics, and treatment modalities. 2015. Available from: https://www.usrds.org/2015/download/vol2_ 01_IncidenceandPrevalence_15.pdf.
  2. 2.
    Amsterdam UMC, location AMC, Department of Medical Informatics, Amsterdam, the Netherlands. ERA-EDTA Registry: ERA-EDTA Registry Annual Report 2016. 2018.Google Scholar
  3. 3.
    The Renal Association. UK Renal Registry. The seventeenth annual report. 2014.Google Scholar
  4. 4.
    T. L. Annual report Norwegian renal registry 2016 2017. 2018. Available from: http://www.nephro.no/registry.html.
  5. 5.
    Scandiatransplant. Annual Scandiatransplant data report. 2017.Google Scholar
  6. 6.
    Port FK, Bragg-Gresham JL, Metzger RA, Dykstra DM, Gillespie BW, Young EW, et al. Donor characteristics associated with reduced graft survival: an approach to expanding the pool of kidney donors1. Transplantation. 2002;74(9):1281–6.PubMedCrossRefPubMedCentralGoogle Scholar
  7. 7.
    Sung RS, Guidinger MK, Lake CD, McBride MA, Greenstein SM, Delmonico FL, et al. Impact of the expanded criteria donor allocation system on the use of expanded criteria donor kidneys. Transplantation. 2005;79(9):1257–61.PubMedCrossRefPubMedCentralGoogle Scholar
  8. 8.
    Schold JD, Howard RJ, Scicchitano MJ, Meier-Kriesche H-U. The expanded criteria donor policy: an evaluation of program objectives and indirect ramifications. Am J Transplant. 2006;6(7):1689–95.PubMedCrossRefPubMedCentralGoogle Scholar
  9. 9.
    Sung RS, Guidinger MK, Leichtman AB, Lake C, Metzger RA, Port FK, et al. Impact of the expanded criteria donor allocation system on candidates for and recipients of expanded criteria donor kidneys. Transplantation. 2007;84(9):1138–44.PubMedCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Dahmane D, Audard V, Hiesse C, Pessione F, Bentaarit B, Barrou B, et al. Retrospective follow-up of transplantation of kidneys from “marginal” donors. Kidney Int. 2006;69(3):546–52.PubMedCrossRefPubMedCentralGoogle Scholar
  11. 11.
    Rao PS, Schaubel DE, Guidinger MK, Andreoni KA, Wolfe RA, Merion RM, et al. A comprehensive risk quantification score for deceased donor kidneys: the kidney donor risk index. Transplantation. 2009;88(2):231–6.PubMedCrossRefPubMedCentralGoogle Scholar
  12. 12.
    Israni AK, Salkowski N, Gustafson S, Snyder JJ, Friedewald JJ, Formica RN, et al. New national allocation policy for deceased donor kidneys in the United States and possible effect on patient outcomes. J Am Soc Nephrol. 2014;25(8):1842–8.PubMedPubMedCentralCrossRefGoogle Scholar
  13. 13.
    Cohen B, Smits JM, Haase B, Persijn G, Vanrenterghem Y, Frei U. Expanding the donor pool to increase renal transplantation. Nephrol Dial Transplant. 2005;20(1):34–41.PubMedCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Frei U, Noeldeke J, Machold-Fabrizii V, Arbogast H, Margreiter R, Fricke L, et al. Prospective age-matching in elderly kidney transplant recipients—a 5-year analysis of the Eurotransplant Senior Program. Am J Transplant. 2008;8(1):50–7.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Collini A, De Bartolomeis C, Ruggieri G, Barni R, Bernini M, Carmellini M. Long-term outcome of renal transplantation from marginal donors. Transplant Proc. 2006;38(10):3398–9.PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    Cicciarelli J, Iwaki Y, Mendez R. The influence of donor age on kidney graft survival in the 1990s. Clin Transplant. 1999;13:335–40.Google Scholar
  17. 17.
    Gjertson DW. A multi-factor analysis of kidney regraft outcomes. Clin Transplant. 2002;2:335–49.Google Scholar
  18. 18.
    Chavalitdhamrong D, Gill J, Takemoto S, Madhira BR, Cho YW, Shah T, et al. Patient and graft outcomes from deceased kidney donors age 70 years and older: an analysis of the Organ Procurement Transplant Network/United Network of Organ Sharing database. Transplantation. 2008;85(11):1573–9.PubMedCrossRefPubMedCentralGoogle Scholar
  19. 19.
    Moers C, Kornmann NSS, Leuvenink HGD, Ploeg RJ. The influence of deceased donor age and old-for-old allocation on kidney transplant outcome. Transplantation. 2009;88(4):542–52.PubMedCrossRefPubMedCentralGoogle Scholar
  20. 20.
    Carrier M, Lizé JF, Québec-Transplant Programs. Impact of expanded criteria donors on outcomes of recipients after kidney transplantation. Transplant Proc. 2012;44(7):2227–30.PubMedCrossRefPubMedCentralGoogle Scholar
  21. 21.
    Schnitzler MA, Lentine KL, Gheorghian A, Axelrod D, Trivedi D, L’Italien G. Renal function following living, standard criteria deceased and expanded criteria deceased donor kidney transplantation: impact on graft failure and death. Transplant Int. 2011;25(2):179–91.CrossRefGoogle Scholar
  22. 22.
    Aubert O, Kamar N, Vernerey D, Viglietti D, Martinez F, Duong-Van-Huyen J-P, et al. Long term outcomes of transplantation using kidneys from expanded criteria donors: prospective, population based cohort study. BMJ. 2015;351:h3557.PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Goldberg RJ, Smits G, Wiseman AC. Long-term impact of donor-recipient size mismatching in deceased donor kidney transplantation and in expanded criteria donor recipients. Transplantation. 2010;90(8):867–74.PubMedCrossRefPubMedCentralGoogle Scholar
  24. 24.
    Mendonça HM, Dos Reis MA, de Castro de Cintra Sesso R, Câmara NOS, Pacheco-Silva A. Renal transplantation outcomes: a comparative analysis between elderly and younger recipients. Clin Transplant. 2007;21(6):755–60.PubMedPubMedCentralGoogle Scholar
  25. 25.
    Hellemans R, Stel VS, Jager KJ, Bosmans JL, Abramowicz D. Do elderly recipients really benefit from kidney transplantation? Transplant Rev. 2015;29(4):197–201.CrossRefGoogle Scholar
  26. 26.
    Wolfe RA, Ashby VB, Milford EL, Ojo AO, Ettenger RE, Agodoa LY, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med. 1999;341(23):1725–30.PubMedCrossRefPubMedCentralGoogle Scholar
  27. 27.
    Port FK, Wolfe RA, Mauger EA, Berling DP, Jiang K. Comparison of survival probabilities for dialysis patients vs cadaveric renal transplant recipients. JAMA. 1993;270(11):1339–43.PubMedCrossRefPubMedCentralGoogle Scholar
  28. 28.
    Heldal K, Hartmann A, Grootendorst DC, de Jager DJ, Leivestad T, Foss A, et al. Benefit of kidney transplantation beyond 70 years of age. Nephrol Dial Transplant. 2010;25(5):1680–7.PubMedCrossRefPubMedCentralGoogle Scholar
  29. 29.
    Gill JS, Tonelli M, Johnson N, Kiberd B, Landsberg D, Pereira BJG. The impact of waiting time and comorbid conditions on the survival benefit of kidney transplantation. Kidney Int. 2005;68(5):2345–51.PubMedCrossRefPubMedCentralGoogle Scholar
  30. 30.
    Lønning K, Midtvedt K, Leivestad T, Reisæter AV, Line P-D, Hartmann A, et al. Are octogenarians with end-stage renal disease candidates for renal transplantation? Transplantation. 2016;100(12):2705–9.PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Huang E, Poommipanit N, Sampaio MS, Kuo H-T, Reddy P, Gritsch HA, et al. Intermediate-term outcomes associated with kidney transplantation in recipients 80 years and older: an analysis of the OPTN/UNOS database. Transplantation. 2010;90(9):974–9.PubMedCrossRefPubMedCentralGoogle Scholar
  32. 32.
    Massie AB, Luo X, Chow EKH, Alejo JL, Desai NM, Segev DL. Survival benefit of primary deceased donor transplantation with high-KDPI kidneys. Am J Transplant. 2014;14(10):2310–6.PubMedCrossRefPubMedCentralGoogle Scholar
  33. 33.
    Kauffman HM, McBride MA, Cors CS, Roza AM, Wynn JJ. Early mortality rates in older kidney recipients with comorbid risk factors. Transplantation. 2007;83(4):404–10.PubMedCrossRefPubMedCentralGoogle Scholar
  34. 34.
    Gill JS, Schaeffner E, Chadban S, Dong J, Rose C, Johnston O, et al. Quantification of the early risk of death in elderly kidney transplant recipients. Am J Transplant. 2013;13(2):427–32.PubMedCrossRefPubMedCentralGoogle Scholar
  35. 35.
    Gill J, Cho YW, Danovitch GM, Wilkinson A, Lipshutz G, Pham P-T, et al. Outcomes of dual adult kidney transplants in the United States: an analysis of the OPTN/UNOS database. Transplantation. 2008;85(1):62–8.PubMedCrossRefPubMedCentralGoogle Scholar
  36. 36.
    Tanriover B, Mohan S, Cohen DJ, Radhakrishnan J, Nickolas TL, Stone PW, et al. Kidneys at higher risk of discard: expanding the role of dual kidney transplantation. Am J Transplant. 2014;14(2):404–15.PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Cruzado JM, Fernandez L, Riera L, Bestard O, Carrera M, Torras J, et al. Revisiting double kidney transplantation: two kidneys provide better graft survival than one. Transplant Proc. 2011;43(6):2165–7.PubMedCrossRefPubMedCentralGoogle Scholar
  38. 38.
    Andrés A, Morales JM, Herrero JC, Praga M, Morales E, Hernández E, et al. Double versus single renal allografts from aged donors. Transplantation. 2000;69(10):2060–6.PubMedCrossRefPubMedCentralGoogle Scholar
  39. 39.
    Frutos MA, Mansilla JJ, Cabello M, Soler J, Ruiz P, Lebrón M, et al. Optimization of expanded donors using dual kidney transplantation: case-control study. Transplant Proc. 2012;44(7):2060–2.PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Snanoudj R, Rabant M, Timsit MO, Karras A, Savoye E, Tricot L, et al. Donor-estimated GFR as an appropriate criterion for allocation of ECD kidneys into single or dual kidney transplantation. Am J Transplant. 2009;9(11):2542–51.PubMedCrossRefPubMedCentralGoogle Scholar
  41. 41.
    Rigotti P, Capovilla G, Di Bella C, Silvestre C, Donato P, Baldan N, et al. A single-center experience with 200 dual kidney transplantations. Clin Transplant. 2014;28(12):1433–40.PubMedCrossRefPubMedCentralGoogle Scholar
  42. 42.
    Medina-Polo J, Pamplona-Casamayor M, Miranda-Utrera N, González-Monte E, Passas-Martínez JB, Andrés Belmonte A. Dual kidney transplantation involving organs from expanded criteria donors: a review of our series and an update on current indications. Transplant Proc. 2014;46(10):3412–5.PubMedCrossRefPubMedCentralGoogle Scholar
  43. 43.
    Ekser B, Furian L, Broggiato A, Silvestre C, Pierobon ES, Baldan N, et al. Technical aspects of unilateral dual kidney transplantation from expanded criteria donors: experience of 100 patients. Am J Transplant. 2010;10(9):2000–7.PubMedCrossRefPubMedCentralGoogle Scholar
  44. 44.
    Garonzik-Wang JM, Govindan P, Grinnan JW, Liu M, Ali HM, Chakraborty A, et al. Frailty and delayed graft function in kidney transplant recipients. Arch Surg. 2012;147(2):190–3.PubMedCrossRefPubMedCentralGoogle Scholar
  45. 45.
    McAdams-Demarco MA, Grams ME, Hall EC, Coresh J, Segev DL. Early hospital readmission after kidney transplantation: patient and center-level associations. Am J Transplant. 2012;12(12):3283–8.PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    Karim A, Farrugia D, Cheshire J, Mahboob S, Begaj I, Ray D, et al. Recipient age and risk for mortality after kidney transplantation in England. Transplantation. 2014;97(8):832–8.PubMedCrossRefPubMedCentralGoogle Scholar
  47. 47.
    Heldal K, Hartmann A, Leivestad T, Foss A, Midtvedt K. Risk variables associated with the outcome of kidney recipients >70 years of age in the new millennium. Nephrol Dial Transplant. 2011;26(8):2706–11.PubMedCrossRefPubMedCentralGoogle Scholar
  48. 48.
    Heldal K, Hartmann A, Leivestad T, Svendsen MV, Foss A, Lien B, et al. Clinical outcomes in elderly kidney transplant recipients are related to acute rejection episodes rather than pretransplant comorbidity. Transplantation. 2009;87(7):1045–51.PubMedCrossRefPubMedCentralGoogle Scholar
  49. 49.
    Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013;14(6):392–7.PubMedPubMedCentralCrossRefGoogle Scholar
  50. 50.
    Anand S, Johansen KL, Kurella-Tamura M. Aging and chronic kidney disease: the impact on physical function and cognition. J Gerontol A Biol Sci Med Sci. 2014;69(3):315–22.PubMedCrossRefPubMedCentralGoogle Scholar
  51. 51.
    Theou O, Brothers TD, Peña FG, Mitnitski A, Rockwood K. Identifying common characteristics of frailty across seven scales. J Am Geriatr Soc. 2014;62(5):901–6.PubMedCrossRefPubMedCentralGoogle Scholar
  52. 52.
    Musso CG, Jauregui JR, Macías Núñez JF. Frailty phenotype and chronic kidney disease: a review of the literature. Int Urol Nephrol. 2015;47(11):1801–7.PubMedPubMedCentralCrossRefGoogle Scholar
  53. 53.
    McAdams-DeMarco MA, Law A, Salter ML, Chow E, Grams M, Walston J, et al. Frailty and early hospital readmission after kidney transplantation. Am J Transplant. 2013;13(8):2091–5.PubMedPubMedCentralCrossRefGoogle Scholar
  54. 54.
    Exterkate L, Slegtenhorst BR, Kelm M, Seyda M, Schuitenmaker JM, Quante M, et al. Frailty and transplantation. Transplantation. 2016;100(4):727–33.PubMedCrossRefPubMedCentralGoogle Scholar
  55. 55.
    Pasina L, Brucato AL, Falcone C, Cucchi E, Bresciani A, Sottocorno M, et al. Medication non-adherence among elderly patients newly discharged and receiving polypharmacy. Drugs Aging. 2014;31(4):283–9.PubMedCrossRefPubMedCentralGoogle Scholar
  56. 56.
    Claxton AJ, Cramer J, Pierce C. A systematic review of the associations between dose regimens and medication compliance. Clin Ther. 2001;23(8):1296–310.PubMedCrossRefPubMedCentralGoogle Scholar
  57. 57.
    Chisholm-Burns MA, Kwong WJ, Mulloy LL, Spivey CA. Nonmodifiable characteristics associated with nonadherence to immunosuppressant therapy in renal transplant recipients. Am J Health Syst Pharm. 2008;65(13):1242–7.PubMedCrossRefPubMedCentralGoogle Scholar
  58. 58.
    Schmid-Mohler G, Thut MP, Wüthrich RP, Denhaerynck K, De Geest S. Non-adherence to immunosuppressive medication in renal transplant recipients within the scope of the integrative model of behavioral prediction: a cross-sectional study. Clin Transpl. 2009;24(2):213–22.CrossRefGoogle Scholar
  59. 59.
    Denhaerynck K, Dobbels F, Cleemput I, Desmyttere A, Schäfer-Keller P, Schaub S, et al. Prevalence, consequences, and determinants of nonadherence in adult renal transplant patients: a literature review. Transpl Int. 2005;18(10):1121–33.PubMedCrossRefPubMedCentralGoogle Scholar
  60. 60.
    Djamali A, Samaniego M, Muth B, Muehrer R, Hofmann RM, Pirsch J, et al. Medical care of kidney transplant recipients after the first posttransplant year. Clin J Am Soc Nephrol. 2006;1(4):623–40.PubMedCrossRefPubMedCentralGoogle Scholar
  61. 61.
    McAdams-DeMarco MA, James N, Salter ML, Walston J, Segev DL. Trends in kidney transplant outcomes in older adults. J Am Geriatr Soc [Internet]. 2014. Available from:  https://doi.org/10.1111/jgs.13130
  62. 62.
    Rose C, Schaeffner E, Frei U, Gill J, Gill JS. A lifetime of allograft function with kidneys from older donors. J Am Soc Nephrol. 2015;26(10):2483–93.PubMedPubMedCentralCrossRefGoogle Scholar
  63. 63.
    Molnar MZ, Streja E, Kovesdy CP, Shah A, Huang E, Bunnapradist S, et al. Age and the associations of living donor and expanded criteria donor kidneys with kidney transplant outcomes. Am J Kidney Dis. 2012;59(6):841–8.PubMedPubMedCentralCrossRefGoogle Scholar
  64. 64.
    Tullius SG, Tran H, Guleria I, Malek SK, Tilney NL, Milford E. The combination of donor and recipient age is critical in determining host immunoresponsiveness and renal transplant outcome. Ann Surg. 2010;252(4):662–74.PubMedPubMedCentralGoogle Scholar
  65. 65.
    Schratzberger G, Mayer G. Age and renal transplantation: an interim analysis. Nephrol Dial Transplant. 2003;18(3):471–6.PubMedCrossRefPubMedCentralGoogle Scholar
  66. 66.
    Balogun SA, Balogun R, Philbrick J, Abdel-Rahman E. Quality of life, perceptions, and health satisfaction of older adults with end-stage renal disease: a systematic review. J Am Geriatr Soc. 2016;65(4):777–85.PubMedCrossRefPubMedCentralGoogle Scholar
  67. 67.
    Lønning K, Heldal K, Bernklev T, Brunborg C, Andersen MH, von der Lippe N, et al. Improved health-related quality of life in older kidney recipients 1 year after transplantation. Transplant Direct. 2018;4(4):e351.PubMedPubMedCentralCrossRefGoogle Scholar
  68. 68.
    Lønning K, Midtvedt K, Bernklev T, Brunborg C, Andersen MH, von der Lippe N, et al. Changes in health-related quality of life in older candidates waiting for kidney transplantation. Nephrology. 2018;23(10):948–56.PubMedCrossRefPubMedCentralGoogle Scholar
  69. 69.
    Murasko DM, Weiner P, Kaye D. Decline in mitogen induced proliferation of lymphocytes with increasing age. Clin Exp Immunol. 1987;70(2):440–8.PubMedPubMedCentralGoogle Scholar
  70. 70.
    Suvas S. Advancing age and immune cell dysfunction: is it reversible or not? Expert Opin Biol Ther. 2008;8(5):657–68.PubMedCrossRefPubMedCentralGoogle Scholar
  71. 71.
    Haynes L, Eaton SM, Burns EM, Randall TD, Swain SL. CD4 T cell memory derived from young naive cells functions well into old age, but memory generated from aged naive cells functions poorly. Proc Natl Acad Sci U S A. 2003;100(25):15053–8.PubMedPubMedCentralCrossRefGoogle Scholar
  72. 72.
    Denecke C, Bedi DS, Ge X, Kim IK-E, Jurisch A, Weiland A, et al. Prolonged graft survival in older recipient mice is determined by impaired effector T-cell but intact regulatory T-cell responses. PLoS One. 2010;5(2):e9232.PubMedPubMedCentralCrossRefGoogle Scholar
  73. 73.
    Rosenberg AS, Sechler JM, Horvath JA, Maniero TG, Bloom ET. Assessment of alloreactive T cell subpopulations of aged mice in vivo. CD4+ but not CD8+ T cell-mediated rejection response declines with advanced age. Eur J Immunol. 1994;24(6):1312–6.PubMedCrossRefPubMedCentralGoogle Scholar
  74. 74.
    Linton PJ. Antigen-independent changes in naive CD4 T cells with aging. J Exp Med. 1996;184(5):1891–900.PubMedCrossRefPubMedCentralGoogle Scholar
  75. 75.
    Mu XY, Thoman ML. The age-dependent cytokine production by murine CD8 T cells as determined by four-color flow cytometry analysis. J Gerontol A Biol Sci Med Sci. 1999;54(3):B116–23.PubMedCrossRefPubMedCentralGoogle Scholar
  76. 76.
    Messaoudi I, Lemaoult J, Guevara-Patino JA, Metzner BM, Nikolich-Zugich J. Age-related CD8 T cell clonal expansions constrict CD8 T cell repertoire and have the potential to impair immune defense. J Exp Med. 2004;200(10):1347–58.PubMedPubMedCentralCrossRefGoogle Scholar
  77. 77.
    Frasca D, Blomberg BB. Effects of aging on B cell function. Curr Opin Immunol. 2009;21(4):425–30.PubMedPubMedCentralCrossRefGoogle Scholar
  78. 78.
    de Fijter JW, Mallat MJ, Doxiadis II, Ringers J, Rosendaal FR, Claas FH, et al. Increased immunogenicity and cause of graft loss of old donor kidneys. J Am Soc Nephrol. 2001;12(7):1538–46.PubMedPubMedCentralGoogle Scholar
  79. 79.
    Arns W, Citterio F, Campistol JM. “Old-for-old”—new strategies for renal transplantation. Nephrol Dial Transplant. 2007;22(2):336–41.PubMedCrossRefPubMedCentralGoogle Scholar
  80. 80.
    Tullius SG, Milford E. Kidney allocation and the aging immune response. N Engl J Med. 2011;364(14):1369–70.PubMedCrossRefPubMedCentralGoogle Scholar
  81. 81.
    Danovitch GM, Gill J, Bunnapradist S. Immunosuppression of the elderly kidney transplant recipient. Transplantation. 2007;84(3):285–91.PubMedCrossRefPubMedCentralGoogle Scholar
  82. 82.
    Jacobson PA, Schladt D, Oetting WS, Leduc R, Guan W, Matas AJ, et al. Lower calcineurin inhibitor doses in older compared to younger kidney transplant recipients yield similar troughs. Am J Transplant. 2012;12(12):3326–36.PubMedPubMedCentralCrossRefGoogle Scholar
  83. 83.
    Meier-Kriesche HU, Ojo AO, Hanson JA, Kaplan B. Exponentially increased risk of infectious death in older renal transplant recipients. Kidney Int. 2001;59(4):1539–43.PubMedCrossRefPubMedCentralGoogle Scholar
  84. 84.
    Heldal K, Midtvedt K. Managing transplant rejection in the elderly: the benefits of less aggressive immunosuppressive regimens. Drugs Aging. 2013;30(7):459–66.PubMedCrossRefPubMedCentralGoogle Scholar
  85. 85.
    Heldal K, Leivestad T, Hartmann A, Svendsen MV, Lien BH, Midtvedt K. Kidney transplantation in the elderly—the Norwegian experience. Nephrol Dial Transplant. 2008;23(3):1026–31.PubMedCrossRefPubMedCentralGoogle Scholar
  86. 86.
    Gill J, Sampaio M, Gill JS, Dong J, Kuo H-T, Danovitch GM, et al. Induction immunosuppressive therapy in the elderly kidney transplant recipient in the United States. Clin J Am Soc Nephrol. 2011;6(5):1168–78.PubMedPubMedCentralCrossRefGoogle Scholar
  87. 87.
    Patel SJ, Knight RJ, Suki WN, Abdellatif A, Duhart BT Jr, Krauss AG, et al. Rabbit antithymocyte induction and dosing in deceased donor renal transplant recipients over 60 yr of age. Clin Transplant. 2011;25(3):E250–6.PubMedCrossRefPubMedCentralGoogle Scholar
  88. 88.
    Heldal K, Thorarinsdottir S, Hartmann A, Leivestad T, Reisæter AV, Foss AE, et al. Induction with interleukin-2 antagonist for transplantation of kidneys from older deceased donors: an observational study. Transplant Res. 2013;2(1):11.PubMedPubMedCentralCrossRefGoogle Scholar
  89. 89.
    Musso CG, Giordani MC, Imperiali N. Aging kidney transplantation. Rev Investig Clin. 2016;68(2):68–74.Google Scholar
  90. 90.
    Musso CG. Geriatric nephrology and the “nephrogeriatric giants”. Int Urol Nephrol. 2002;34(2):255–6.PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Internal Medicine DepartmentHospital Italiano de Buenos AiresBuenos AiresArgentina
  2. 2.Clinic of Internal MedicineTelemark Hospital TrustSkienNorway
  3. 3.Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway
  4. 4.Department of Transplantation Medicine, Section of NephrologyOslo University HospitalOsloNorway

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