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. 2012 Oct;12(10):2608-22.
doi: 10.1111/j.1600-6143.2012.04245.x. Epub 2012 Sep 7.

Solid-organ transplantation in older adults: current status and future research

M Abecassis  1 , N D Bridges, C J Clancy, M A Dew, B Eldadah, M J Englesbe, M F Flessner, J C Frank, J Friedewald, J Gill, C Gries, J B Halter, E L Hartmann, W R Hazzard, F M Horne, J Hosenpud, P Jacobson, B L Kasiske, J Lake, R Loomba, P N Malani, T M Moore, A Murray, M-H Nguyen, N R Powe, P P Reese, H Reynolds, M D Samaniego, K E Schmader, D L Segev, A S Shah, L G Singer, J A Sosa, Z A Stewart, J C Tan, W W Williams, D W Zaas, K P High
Affiliations

Solid-organ transplantation in older adults: current status and future research

M Abecassis et al. Am J Transplant. 2012 Oct.

Abstract

An increasing number of patients older than 65 years are referred for and have access to organ transplantation, and an increasing number of older adults are donating organs. Although short-term outcomes are similar in older versus younger transplant recipients, older donor or recipient age is associated with inferior long-term outcomes. However, age is often a proxy for other factors that might predict poor outcomes more strongly and better identify patients at risk for adverse events. Approaches to transplantation in older adults vary across programs, but despite recent gains in access and the increased use of marginal organs, older patients remain less likely than other groups to receive a transplant, and those who do are highly selected. Moreover, few studies have addressed geriatric issues in transplant patient selection or management, or the implications on health span and disability when patients age to late life with a transplanted organ. This paper summarizes a recent trans-disciplinary workshop held by ASP, in collaboration with NHLBI, NIA, NIAID, NIDDK and AGS, to address issues related to kidney, liver, lung, or heart transplantation in older adults and to propose a research agenda in these areas.

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Conflict of interest statement

Disclosure

The authors have no conflicts of interest to disclose as described by the American Journal of Transplantation.

Figures

Figure 1
Figure 1
Proportion of patients on transplant waiting lists, by age (1), for (A) kidney, (B) liver, (C) lung, and (D) heart.
Figure 2
Figure 2
Transplant rates for adults on the waiting list, by age (1), for (A) kidney, (B) liver, (C) lung, and (D) heart.
Figure 3
Figure 3
Proportion of donor organs discarded, by age. (A) kidney, (B) liver. (Based on data from the United Network for Organ Sharing (UNOS) Standard Transplant Analysis and Research (STAR)).
Figure 4
Figure 4
Changes in glomerular filtration rate (GFR) and glomerulare number, by age. (A) Changes in GFR (17). (B) Changes in glomerular number, estimated from autopsy studies (14). (C) Changes in glomerular number from deceased donors, estimated by combining renal physiology with morphometry from kidney biopsies, compared with estimates from autopsy studies (16). (D) Changes in glomerular number from living donors, estimated by combining renal physiology with morphometry from kidney biopsies (15).
See this image and copyright information in PMC

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