| Theme |
Reconsidering dialysis initiation for the elderly |
| Title |
Current status and indications for renal transplantation in elderly patients |
| Author |
Atsushi Aikawa |
Department of Nephrology, Toho University School of Medicine |
| Author |
Takeshi Kawamura |
Department of Nephrology, Toho University School of Medicine |
| [ Summary ] |
The number of the elderly kidney transplant recipients has increased as spousal kidney transplantation has become more common. The number of elderly recipients over 60 years of age, accounts for approximately 20 % of the total number of kidney transplants. The characteristics of elderly kidney transplant recipients tend to include a low incidence of acute rejection. However, many die of serious infections. Five year patient and graft survival rates are under 90 % but death-censored graft survival rates are similar to those observed in other age groups. Elderly recipients tend to be excessively immunosuppressed. However, graft function frequently deteriorates due to chronic allograft nephropathy once a recipient develops acute rejection. The number of elderly living donors has increased yearly, to 43.6 % in 2014. Close follow-ups are necessary after donor nephrectomies to protect elderly living donors them from renal failure. Kidney transplantation for elderly patients can provide better survival rates and a better quality of life than dialysis. Relatively good graft survival rates are possible, despite high incidences of serious infection. |