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Author Topic: Vital Transplant Organs Scarce for Seniors  (Read 3142 times)

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Offline Clark

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Vital Transplant Organs Scarce for Seniors
« on: January 19, 2012, 04:13:52 PM »

Vital Transplant Organs Scarce for Seniors

A new study by Johns Hopkins researchers published in the January issue of the Journal of the American Geriatrics Society, has revealed that thousands of U.S. senior citizens with kidney disease are good candidates for transplants and would be able to receive them if physicians would overcome past outdated medical biases and put these patients on transplant waiting lists.

The Hopkins researchers estimate that about 9,000 adults over the age of 65 years had been classed as "excellent" transplant candidates between 1999 and 2006, with an estimated 40,000 older adults classed as "good" candidates. However, none were given the opportunity.

Transplant surgeon Dr. Dorry L. Segev, an associate professor of surgery at the Johns Hopkins University School of Medicine and leader of the study, commented:

"Doctors routinely believe and tell older people they are not good candidates for kidney transplant, but many of them are if they are carefully selected and if factors that really predict outcomes are fully accounted for. Many older adults can enjoy excellent transplant outcomes in this day and age and should be given consideration for this lifesaving treatment."

People age 65 and older represent more than one-half of people with end-stage renal disease in the U.S., and according to Segev, appropriately selected patients in this age group will live longer if they receive new kidneys, rather than remaining on dialysis. He adds that the problem is that very few older adults are placed on transplant waiting lists.

Only 10.4% of dialysis patients aged between 65 and 74 years were on waiting lists in 2007, whilst 33.5% of those aged between 18 and 44 years, and 21.9% of patients between 45 and 64 years, were placed on a kidney transplant waiting list. Segev points out that some older kidney disease patients are indeed poor transplant prospects due to other age-related health problems, but adds that the new findings coupled with other recent research demonstrates that new organs can greatly improve survival even in this age group.

Segev and his colleagues decided to design a statistical model for predicting how well older adults would be expected to do following kidney transplantation. They accounted for age, smoking, diabetes and 16 other health-related variables and subsequently used those data to define what makes an "excellent" candidate. The measure was then applied to every dialysis patient over the age of 65 years for the duration of the seven-year study period. The researchers also noted whether these candidates were already on the waiting list.

Segev declares:

"We have this regressive attitude toward transplantation in older adults, one based on historical poor outcomes in older patients, which no longer hold up. Anyone who can benefit from kidney transplantation should at least be given a chance. They should at least be put on the list."

He adds that he is aware of the shortage of kidneys and that some people will question whether scarce organs would be put to better use in younger patients, but he argues that his study predicts that over 10% of older patients would receive a donor kidney from a living relative or friend, which would have little impact on the nationwide shortage of deceased donor kidneys. However, in order to find a living donor, patients' must first be referred for transplantation.

He states:

"By not referring older adults for transplant, we're not just denying them a chance at a kidney from a deceased donor, but we're potentially denying them a kidney from a live donor."

Last year Segev and his colleagues published findings in the Journal of the American Medical Association which determined that live kidney donation is very safe for both donor and recipient, with more older adults donating their kidneys to relatives. Other previous studies by Segev demonstrated that older kidney transplant recipients are doing fine with kidneys from older donors, which are organs that would otherwise be rejected for transplants in younger patients.

Written by Petra Rattue
Unrelated directed kidney donor in 2003, recipient and I both well.
625 time blood and platelet donor since 1976 and still giving!
Elected to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, and Ad Hoc Public Solicitation of Organ Donors Committees, 2005-2011
Proud grandpa!


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