Kidney transplantation in the elderly.
OBJECTIVE
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.


RESULTS
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.


CONCLUSIONS
Despite improved outcomes, there remain significant challenges to kidney transplantation in the elderly, including organ shortage, poor transplant rate, evolving allocation policies, high wait-list mortality and nonstandardized immunosuppression. Prospective studies are needed to evaluate the strategies to meet these challenges and to study the impact of proposed new allocation system.
Singh
Neeraj
N
Division of Transplantation, Department of Nephrology, The Ohio State University Medical Center, Columbus, Ohio 43210, USA. neeraj.singh@osumc.edu
Nori
Uday
U
Pesavento
Todd
T
D000367:Age Factors; D006291:Health Policy; D006299:Health Services for the Aged / Q000941:ethics; D006801:Humans; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation / Q000009:adverse effects / Q000941:ethics; D018579:Patient Selection / Q000941:ethics; D014019:Tissue Donors / Q000941:ethics / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000941:ethics / Q000458:organization & administration*; D016896:Treatment Outcome; D014481:United States; D014850:Waiting Lists