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Elderly Transplant Recipients

  • Aparna Rege
  • Aditya Nanavati
  • Todd V. Brennan
Living reference work entry

Abstract

There is a proven benefit of transplantation for the elderly in terms of quality of life and survival advantage over alternative therapies like dialysis. Frailty, comorbidity, access to transplantation, increasing wait time, and delayed allograft function negatively affect transplant outcomes for the elderly. Age-related comorbidities increase the risk of early mortality for seniors undergoing transplant. Pretransplantation activity and baseline cognitive function may impact suitability for transplantation and should carefully be considered during the selection process. The aging immune system, age-associated alterations in drug pharmacokinetics, and the risk associated with over-immunosuppression can make immunosuppression management a challenge in this population. Lack of adequate social support and finances can account for noncompliance leading to a poor outcome. When all these factors are taken into consideration, selective geriatric candidates can experience comparable benefits from transplantation as younger candidates. This chapter provides a concise review of factors that can make transplantation a success in the geriatric population.

Keywords

Geriatric Transplantation Risk Frailty Selection Outcomes 

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Aparna Rege
    • 1
  • Aditya Nanavati
    • 1
  • Todd V. Brennan
    • 1
  1. 1.Division of Abdominal Transplant, Department of SurgeryDuke University Medical CenterDurhamUSA

Section editors and affiliations

  • Jason Johanning
    • 1
  • Sandhya Lagoo-Deenadayalan
    • 2
  1. 1.Department of SurgeryUniversity of Nebraska Medical CenterOmahaUSA
  2. 2.Duke MedicineDurhamUSA

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