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When are you too old to get a kidney transplants?

Kodali, Lavanyaa; Turner, Alexandrab

Current Opinion in Nephrology and Hypertension: November 2019 - Volume 28 - Issue 6 - p 593–599
doi: 10.1097/MNH.0000000000000548
DIALYSIS AND TRANSPLANTATION: Edited by Anil Chandraker and J. Kevin Tucker

Purpose of review With the increasing incidence and prevalence of ESRD in the elderly, we are now transplanting more elderly patients. Although we know from previous reports that transplantation provides increased survival advantage and/or quality of life when compared to being on dialysis, we also know that transplantation is not the best option for all patients. In this review, we try to identify the upper age limit (if any) for deceased donor renal transplantation, predictive factors that can identify the risks for transplant outcomes, frailty, and immunosenescence.

Recent findings Review of data over the last 5 years have identified certain risk predictors and outcomes that might be helpful in evaluation of the elderly transplant recipient, which we aim to summarize in this review.

Summary Identifying predictors to risk stratify elderly patients and promote transplantation is much needed. Modifiable risks should be addressed to ensure more candidates become transplantable. A combination of physical, medical, and immunological markers to better identify recipients is imperative for future research gearing towards precision medicine.

aDepartment of Medicine, Division of Nephrology, Mayo Clinic

bDepartment of Surgery, University of Arizona School of Medicine, Tucson, Arizona, USA

Correspondence to Dr Lavanya Kodali, 5779 E Mayo Blvd, Phoenix, Arizona, USA. Tel: +1 480 342 4745; fax: +1 480 342 3033; e-mail:

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