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Elderly Transplant Recipients

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Principles and Practice of Geriatric Surgery

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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.

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Authors and Affiliations

  1. Division of Abdominal Transplant, Department of Surgery, Duke University Medical Center, 27514, DUMC Box 3512, Durham, NC, USA

    Aparna Rege, Aditya Nanavati & Todd V. Brennan

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  1. Aparna Rege
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  2. Aditya Nanavati
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  3. Todd V. Brennan
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Correspondence to Aparna Rege .

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Editors and Affiliations

  1. Surgical Service, Yale University School of Medicine VA Connecticut Health Care System, West Haven, Connecticut, USA

    Ronnie A. Rosenthal

  2. SUNY Downstate School of Public Health, National Capital Region Johns Hopkins Medicine, Bethesda, Maryland, USA

    Michael E. Zenilman

  3. Center for Geriatric Surgery, Sinai Hospital of Baltimore, Baltimore, Maryland, USA

    Mark R. Katlic

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  1. Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA

    Jason Johanning

  2. Duke Medicine, Durham, NC, USA

    Sandhya Lagoo-Deenadayalan

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Rege, A., Nanavati, A., Brennan, T.V. (2017). Elderly Transplant Recipients. In: Rosenthal, R., Zenilman, M., Katlic, M. (eds) Principles and Practice of Geriatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-20317-1_56-1

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