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. 2023 Jul 5:36:11296.
doi: 10.3389/ti.2023.11296. eCollection 2023.

Old Age and Frailty in Deceased Organ Transplantation and Allocation-A Plea for Geriatric Assessment and Prehabilitation

Arved Weimann  1 , Marlies Ahlert  2 , Daniel Seehofer  3 , Tania Zieschang  4 , Mark Schweda  5
Affiliations

Old Age and Frailty in Deceased Organ Transplantation and Allocation-A Plea for Geriatric Assessment and Prehabilitation

Arved Weimann et al. Transpl Int. .

Abstract

Due to demographic ageing and medical progress, the number and proportion of older organ donors and recipients is increasing. At the same time, the medical and ethical significance of ageing and old age for organ transplantation needs clarification. Advanced age is associated with the frailty syndrome that has a negative impact on the success of organ transplantation. However, there is emerging evidence that frailty can be modified by suitable prehabilitation measures. Against this backdrop, we argue that decision making about access to the transplant waiting list and the allocation of donor organs should integrate geriatric expertise in order to assess and manage frailty and impairments in functional capacity. Prehabilitation should be implemented as a new strategy for pre-operative conditioning of older risk patients' functional capacity. From an ethical point of view, advanced chronological age per se should not preclude the indication for organ transplantation and the allocation of donor organs.

Keywords: frailty; old age; organ allocation; organ transplantation; prehabilitation.

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Conflict of interest statement

AW received a research grant for a project on prehabilitation from B. Braun on an institutional account. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Multimodal prehabilitation.
See this image and copyright information in PMC

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