Elderly Transplant Recipients

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.

Duke Scholars

Author Aparna Sharad Rege Surgery, Abdominal Transplant Surgery