ReviewFrontiers in immunology2020
Transplanting the Elderly: Mandatory Age- and Minimal Histocompatibility Matching.
Review in Frontiers in immunology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 33 citations in OpenAlex.
- Necessity of induction agent modification for old age kidney transplant recipients.Kidney research and clinical practice · 2025Article
- Age-modified risk factors for mortality of non-elderly adult kidney transplant recipients: a retrospective database analysis.International urology and nephrology · 2024Article
- Article
- Association of Senescence Markers with Age and Allograft Rejection in Renal Transplant Recipients.Biomedicines · 2024Article
- Old for young kidney transplantation: a responsible option for our patients to reduce waiting time?World journal of urology · 2024Article
- Renal Replacement Therapy For Elderly Patients with ESKD Through Shared Decision-Making.Electrolyte & blood pressure : E & BP · 2023Review
- Posttransplant Diabetes Mellitus and Immunosuppression Selection in Older and Obese Kidney Recipients.Kidney medicine · 2022Article
- Immunosuppression Regimen Use and Outcomes in Older and Younger Adult Kidney Transplant Recipients: A National Registry Analysis.Transplantation · 2021Article
- Hypoproliferative human neural progenitor cell xenografts survived extendedly in the brain of immunocompetent rats.Stem cell research & therapy · 2021Article
- Immunosuppression Considerations for Older Kidney Transplant Recipients.Current transplantation reports · 2021Article
- Should We Perform Old-for-Old Kidney Transplantation during the COVID-19 Pandemic? The Risk for Post-Operative Intensive Stay.Journal of clinical medicine · 2020Article
- Impact of Combinations of Donor and Recipient Ages and Other Factors on Kidney Graft Outcomes.Frontiers in immunology · 2020Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Worldwide over 40% of patients receiving renal replacement therapy (RRT) are aged 65 years or older, a number that is still increasing. Renal transplantation is the preferred RRT, providing substantial survival benefit over those remaining on dialysis, including the elderly. Only 3% of patients aged 65 years or older accepted on the waiting list actually received a kidney transplant offer within the Eurotransplant allocation region. To increase the chance for elderly to receive a timely kidney transplant, the Eurotransplant Senior Program was introduced. The ESP supports local allocation of older kidneys to older donors in order to decrease cold ischemia time, while disregarding former exchange principles based on matching for HLA antigens. As a consequence, more elderly received a kidney transplant and a relative higher incidence of acute rejection resulted in additional courses of high steroids and/or depleting antibody therapy. Since death with a functioning graft due to infections is the dominant reason of graft loss in elderly, more intense clinical immunosuppression to prevent or treat acute rejection is not a very attractive option. Therefore in elderly kidney transplant candidates, we advocate reintroduction of minimal histocompatibility criteria (i.e., HLA-DR matching) followed by age-matching with mandatory local/regional allocation to also facilitate short cold ischemia.
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