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Elderly and kindey transplant

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43 papers 0 to 25 followers Isabel Rentería Residente Nefrologia Hospital Univeristario de Maracaibo Zulia Venezuela
By Isabel Renteria Nefrology
Enrique Morales, Eduardo Gutiérrez, Ana Hernández, Jorge Rojas-Rivera, Esther Gonzalez, Eduardo Hernández, Natalia Polanco, Manuel Praga, Amado Andrés
BACKGROUND: The shortage of organs is a major hurdle in kidney transplantation, and one solution to the problem is to extend the age of the donor. However, organs from older donors are often discarded due to the macroscopic appearance of the parenchyma or major vessels. On the other hand, a large number of elderly patients are potential candidates for kidney transplantation, while many kidneys from elderly deceased donors are discarded due to a lack of age-matched recipients. In addition, a large number are often discarded due to the lack of compatible recipients among elderly patients undergoing chronic dialysis...
2015: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Cécile Couchoud, Michel Labeeuw, Olivier Moranne, Vincent Allot, Vincent Esnault, Luc Frimat, Bénédicte Stengel
AIM: The aim of this study was to develop and validate a prognostic score for 6-month mortality in elderly patients starting dialysis for end-stage renal disease. METHODS: Using data from the French Rein registry, we developed a prognostic score in a training sample of 2500 patients aged 75 years or older who started dialysis between 2002 and 2006, which we validated in a similar sample of 1642 patients. Multivariate logistic regression with 500 bootstrap samples allowed us to select risk factors from 19 demographic and baseline clinical variables...
May 2009: Nephrology, Dialysis, Transplantation
(no author information available yet)
A. Because renal transplantation can extend the duration and quality of life in elderly patients (age 60-70 years) with end-stage renal disease, transplantation should be considered in all patients, particularly if special programmes and preparations are applied. B. In elderly kidney transplant recipients, immunosuppression has to be adapted to avoid both rejections and adverse effects. C. Accurate diagnosis and aggressive treatment of cardiovascular disease in elderly recipients are recommended because of the high number of deaths with functioning grafts...
2002: Nephrology, Dialysis, Transplantation
Neeraj Singh, Uday Nori, Todd Pesavento
PURPOSE OF REVIEW: Recent outcome data, ongoing organ shortage and proposed changes in allocation policies are driving the need to review current practices and possible future course of kidney transplantation in the elderly patients. RECENT FINDINGS: A proposed new kidney allocation system based on matching donor and recipient characteristics to enable 'age-matched' kidney allocation is currently being discussed in the USA. While this system benefits younger recipients, implications for elderly recipients receiving older grafts remain a matter of debate...
August 2009: Current Opinion in Organ Transplantation
Dean Markić, Maksim Valencić, Romano Oguić, Sanjin Racki, Zeljko Fuckar
The Eurotransplant Senior Program (ESP) allocates kidneys from elderly donors to elderly recipients (> or = 65 years old). During the last 39 years, 922 kidney transplantations were performed in our transplant center. We retrospectively analysed patients included in the ESP from the our center. Eleven patients > or = 65 years old recieved kidney from donors 65 years old. Cold ischemia time was approximately 15 hours. Dual kidney transplantation was performed in one patient. Appropriate immunosuppressive protocol was given to all patients...
September 2011: Collegium Antropologicum
Edmund Huang, Dorry L Segev, Hamid Rabb
There is an increase in the older incident end-stage renal disease population that is associated with an increasing prevalence of end-stage renal disease in the United States. This trend is paralleled by an increasing rate of kidney transplantation in the elderly. Although patient survival is lower in older versus younger kidney recipients, the elderly benefit from a reduction in mortality rate and improved quality of life with transplantation compared with dialysis. Immunologic, physiologic, and psychosocial factors influence transplant outcomes and should be recognized in the care of the elderly transplant patient...
November 2009: Seminars in Nephrology
Jacob A Akoh, Umasankar Mathuram Thiyagarajan
Acceptance of elderly living kidney donors remains controversial due to the higher incidence of comorbidity and greater risk of postoperative complications. This is a review of publications in the English language between 2000 and 2013 about renal transplantation from elderly living donors to determine trends and effects of donation, and the outcomes of such transplantation. The last decade witnessed a 50% increase in living kidney donor transplants, with a disproportionate increase in donors >60 years. There is no accelerated loss of kidney function following donation, and the incidence of established renal failure (ERF) and hypertension among donors is similar to that of the general population...
2013: Journal of Transplantation
Paola Karina García, Carlos Alberto Cano, Camilo Alberto González, Ronald Leonel García, Mady Arroyave
INTRODUCTION: Kidney transplantation is the treatment of choice in patients with end- stage renal disease. Renal transplantation in without fear of ethical conflicts is the best treatment option in the elderly. The objective is to describe the demographic and clinical characteristics of patients over 60 years old with at least one year of renal transplantation in a single center of Colombia. METHODS: This is a cohort study of patients over 60 years old from a single center in Bogota, Colombia...
May 2014: Revista Española de Geriatría y Gerontología
Suphamai Bunnapradist, Gabriel M Danovitch
No abstract text is available yet for this article.
November 2010: Clinical Journal of the American Society of Nephrology: CJASN
Sarbjit V Jassal, Murray D Krahn, Gary Naglie, Jeffrey S Zaltzman, Janet M Roscoe, Edward H Cole, Donald A Redelmeier
Transplantation offers superior life expectancy and quality of life compared with dialysis in young patients with end-stage renal failure. However, the initial risks of mortality and morbidity are high. This study used a decision analysis model to evaluate the costs and benefits of kidney transplantation versus continued dialysis for older patients with renal failure. A decision analytic model comparing cadaveric renal transplantation to continued hemodialysis treatment was developed. The base case considered a theoretical cohort of patients aged 65 yr without known comorbidity or contraindications to transplantation who would have to wait 2 yr for a cadaveric transplant...
January 2003: Journal of the American Society of Nephrology: JASN
Christine Wu, Ron Shapiro, Henkie Tan, Amit Basu, Cynthia Smetanka, Claire Morgan, Nirav Shah, Jerry McCauley, Mark Unruh
OBJECTIVES: To examine the extent to which donor and recipient characteristics were associated with transplant outcomes in elderly kidney transplant recipients. DESIGN: Retrospective review. SETTING: Single university center. PARTICIPANTS: One thousand one hundred two patients, including 266 patients aged 60 and older. MEASUREMENTS: Recipient and donor characteristics and patient and graft outcomes...
February 2008: Journal of the American Geriatrics Society
Kristian Heldal, Torbjørn Leivestad, Anders Hartmann, Martin Veel Svendsen, Bjørn Herman Lien, Karsten Midtvedt
BACKGROUND: Elderly patients are the fastest growing population requiring renal replacement therapy. With increasing scarcity of organs, old patients are likely to remain in dialysis. We have had an active transplant program with elderly patients (i.e. > or = 70 years) and present results from our experiences. METHODS: From 1990 throughout 2005, we performed 301 first kidney transplantations in elderly patients. Data were compared with 513 senior patients aged 60-69 years and 512 control patients, aged 45-54 years, transplanted during the same time period...
March 2008: Nephrology, Dialysis, Transplantation
Nathaniel Berman, Kaylan Christianer, Jordan Roberts, Rachel Feldman, M Cary Reid, Rouzi Shengelia, Jeanne Teresi, Joseph Eimicke, Brian Eiss, Ronald Adelman
BACKGROUND: Patients with end-stage renal disease (ESRD) on hemodialysis (HD) suffer from a high symptom burden. However, there is significant heterogeneity within the HD population; certain subgroups, such as the elderly, may experience disproportionate symptom burden. OBJECTIVES: The study's objective was to propose a category of HD patients at elevated risk for symptom burden (those patients who are not transplant candidates) and to compare symptomatology among transplant ineligible versus eligible HD patients...
November 2013: Journal of Palliative Medicine
Paul L Tso
The benefits of renal transplantation have been demonstrated to extend to the elderly. As a result, more seniors have been placed on the kidney transplant wait list and have received renal allografts in recent years. In June 2013 significant amendments to deceased donor kidney allocation policy were approved to be instituted in 2014 with the goal of increasing overall life years and graft years achieved compared to the current system. Going forward, it is conceivable that transplant centers may perceive a need to adjust practice patterns and modify evaluation and listing criteria for the elderly as the proportion of kidneys distributed to this segment of the wait list would potentially decrease under the new system, further increasing wait times...
January 2014: Transplantation Reviews
U Frei, J Noeldeke, V Machold-Fabrizii, H Arbogast, R Margreiter, L Fricke, A Voiculescu, V Kliem, H Ebel, U Albert, K Lopau, P Schnuelle, B Nonnast-Daniel, F Pietruck, R Offermann, G Persijn, C Bernasconi
Renal transplantation faces challenges: the organ shortage resulting in extended waiting times and an aging population resulting in death with a functioning graft. The Eurotransplant Senior Program (ESP) allocates kidneys within a narrow geographic area from donors aged >/=65 years to recipients >/=65 years regardless of HLA. This analysis investigates the impact of the ESP on waiting time, graft and patient survival. The ESP group (n = 1406, old to old) was compared to two groups allocated via the Eurotransplant Kidney Allocation System (ETKAS) with either similar donor age (old to any [O/A], donor age >/=65, n = 446) or recipient age (any to old, [A/O], recipient age 60-64, n = 1687)...
January 2008: American Journal of Transplantation
M G J Snoeijs, S Schaefer, M H Christiaans, J P van Hooff, P M van den Berg-Loonen, C J Peutz-Kootstra, W A Buurman, L W E van Heurn
Although acceptable outcomes have been reported in both non-heart-beating (NHB) and elderly donors individually, the large pool of elderly NHB donors has not yet been fully utilized. In 1994, we expanded our transplant protocol to include NHB donors aged over 65 years and this study compares the clinical outcomes with regular NHB transplantations. Up to June 2005, 24 patients were transplanted at our center with kidneys from NHB donors aged 65 years or more, whereas 176 patients received grafts from conventional NHB donors during the same period...
May 2006: American Journal of Transplantation
Elke S Schaeffner, Caren Rose, John S Gill
BACKGROUND AND OBJECTIVES: Few elderly ESRD patients are ever wait-listed for deceased-donor transplantation (DDTX), and waiting list outcomes may not reflect access to transplantation in this group. Our objective was to determine longitudinal changes in access to transplantation among all elderly patients with ESRD, not just those wait-listed for DDTX. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using data from the US Renal Data System, we determined changes in the adjusted likelihood of transplantation from any donor source as an indicator of access to transplantation among all incident ESRD patients aged 60 to 75 years between 1995 and 2006...
November 2010: Clinical Journal of the American Society of Nephrology: CJASN
Ralf Bahde, Thorsten Vowinkel, Julia Unser, Christoph Anthoni, Jens Peter Hölzen, Barbara Suwelack, Norbert Senninger, Heiner H Wolters
BACKGROUND: The shortage of organ donors has led to the introduction of the Eurotransplant Senior Program (ESP) to optimize the allocation of kidneys from elderly donors by age-matching. In the face of a rapidly aging population, identification of prognostic factors for kidney allograft survival within the ESP population will be of enormous significance. MATERIAL AND METHODS: Donor and recipient data from 89 patients transplanted under the ESP protocol between 1999 and 2007 were retrospectively analyzed...
2014: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Massimiliano Veroux, Giuseppe Grosso, Daniela Corona, Antonio Mistretta, Alessia Giaquinta, Giuseppe Giuffrida, Nunzia Sinagra, Pierfrancesco Veroux
BACKGROUND: Donor and recipient age may have an impact on the renal transplant outcome. Kidney transplantation from older donors may result in a worse outcome, and the survival benefit of kidney transplantation compared with dialysis may be reduced. The aim of this study was to evaluate the impact of donor and recipient age on kidney transplant outcome. MATERIALS AND METHODS: Two hundred and twenty-three recipients of kidney transplants performed at our institution between 2002 and 2007 were analysed...
April 2012: Nephrology, Dialysis, Transplantation
Michèle Kessler, Mathias Büchler, Dominique Durand, Anne Kolko-Labadens, Gaelle Lefrançois, Victorio Menoyo, Georges Mourad, Marie-Noelle Peraldi, Claire Pouteil-Noble, Laurent Yver, Brigitte Zins, Maryvonne Hourmant
Practices for enrollment on kidney transplantation waiting lists are variable between geographical areas and centers. Early referral of patients with chronic renal failure (CRF) to a nephrologist, particularly one practicing in a transplantation center, is a prerequisite to early enrollment. Despite improved survival in elderly transplant recipients, being aged over 65 years is still a barrier against enrollment. Furthermore certain comorbid conditions such as diabetes mellitus are often wrongly considered as contraindications for transplantation...
June 2008: Néphrologie & Thérapeutique
2015-03-16 01:25:21
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