Thousands more American senior citizens with kidney disease are good candidates for transplants but physicians are not putting them on transplant waiting lists, a new study by Johns Hopkins researchers shows.
The Hopkins investigators estimate that between 1999 and 2006, roughly 9,000 adults over 65 would have been “excellent” transplant candidates and approximately 40,000 more older adults would have been “good” candidates for new kidneys. None, however, were given the chance.
“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,” says transplant surgeon Dr. Dorry L. Segev, an associate professor of surgery at the Johns Hopkins University School of Medicine and leader of the study being published in the January issue of the Journal of the American Geriatric Society.
“Many older adults can enjoy excellent transplant outcomes in this day and age,” he said, and should “be given consideration for this lifesaving treatment.”
Those ages 65 and older make up over one-half of people with end-stage renal disease in the United States, and appropriately selected patients in this age group will live longer if they get new kidneys as opposed to remaining on dialysis, Dr. Segev said. The trouble is, he added, that very few older adults are even put on transplant waiting lists. In 2007, only 10.4 per cent of dialysis patients between the ages of 65 and 74 were on waiting lists, compared to 33.5 per cent of 18- to 44-year-old dialysis patients and 21.9 per cent of 45- to 64-year-old dialysis patients.
Dr. Segev cautioned that some older kidney disease patients are indeed poor transplant prospects, because they have other age-related health problems. But he said his team’s new findings, in addition to other recent research, show that new organs can greatly improve survival even in this age group.
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