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Criteria for and Appropriateness of Renal Transplantation in Elderly Patients With End-Stage Renal Disease : A Literature Review and Position Statement on Behalf of the European Renal Association-European Dialysis and Transplant Association Descartes Working Group and European Renal Best Practice. / Segall, Liviu; Nistor, Ionuţ; Pascual, Julio; Mucsi, Istvan; Guirado, Lluis; Higgins, Robert; Van Laecke, Steven; Oberbauer, Rainer; Van Biesen, Wim; Abramowicz, Daniel; Gavrilovici, Cristina; Farrington, Ken; Covic, Adrian.

In: Cell Transplantation, Vol. 100, No. 10, 01.10.2016, p. e55-65.

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Segall, Liviu ; Nistor, Ionuţ ; Pascual, Julio ; Mucsi, Istvan ; Guirado, Lluis ; Higgins, Robert ; Van Laecke, Steven ; Oberbauer, Rainer ; Van Biesen, Wim ; Abramowicz, Daniel ; Gavrilovici, Cristina ; Farrington, Ken ; Covic, Adrian. / Criteria for and Appropriateness of Renal Transplantation in Elderly Patients With End-Stage Renal Disease : A Literature Review and Position Statement on Behalf of the European Renal Association-European Dialysis and Transplant Association Descartes Working Group and European Renal Best Practice. In: Cell Transplantation. 2016 ; Vol. 100, No. 10. pp. e55-65.

Bibtex

@article{b57beb027e774801a6ef39306053e2ba,
title = "Criteria for and Appropriateness of Renal Transplantation in Elderly Patients With End-Stage Renal Disease: A Literature Review and Position Statement on Behalf of the European Renal Association-European Dialysis and Transplant Association Descartes Working Group and European Renal Best Practice",
abstract = "During the last 20 years, waiting lists for renal transplantation (RT) have grown significantly older. However, elderly patients (ie ≥65 years of age) are still more rarely referred or accepted to waiting lists and, if enlisted, have less chances of actually receiving a kidney allograft, than younger counterparts. In this review, we looked at evidence for the benefits and risks of RT in the elderly trying to answer the following questions: Should RT be advocated for elderly patients? What should be the criteria to accept elderly patients on the waiting list for RT? What strategies might be used to increase the rate of RT in waitlisted elderly candidates? For selected elderly patients, RT was shown to be superior to dialysis in terms of patient survival. Virtually all guidelines recommend that patients should not be deemed ineligible for RT based on age alone, although a short life expectancy generally might preclude RT. Concerning the assessment of comorbidities in the elderly, special attention should be paid to cardiac evaluation and screening for malignancy. Comorbidity scores and frailty assessment scales might help the decision making on eligibility. Psychosocial issues should also be evaluated. To overcome the scarcity of organ donors, elderly RT candidates should be encouraged to consider expanded criteria donors and living donors, as alternatives to deceased standard criteria donors. It has been demonstrated that expanded criteria donor RT in patients 60 years or older is associated with higher survival rates than remaining on dialysis, whereas living donor RT is superior to all other options.",
keywords = "Adult, Aged, Cardiovascular Diseases, Frail Elderly, Humans, Kidney Failure, Chronic, Kidney Transplantation, Middle Aged, Neoplasms, Renal Dialysis, Risk Reduction Behavior, Journal Article, Review",
author = "Liviu Segall and Ionu{\c t} Nistor and Julio Pascual and Istvan Mucsi and Lluis Guirado and Robert Higgins and {Van Laecke}, Steven and Rainer Oberbauer and {Van Biesen}, Wim and Daniel Abramowicz and Cristina Gavrilovici and Ken Farrington and Adrian Covic",
year = "2016",
month = oct,
day = "1",
doi = "10.1097/TP.0000000000001367",
language = "English",
volume = "100",
pages = "e55--65",
journal = "Cell Transplantation",
issn = "0963-6897",
publisher = "Cognizant Communication Corporation",
number = "10",

}

RIS

TY - JOUR

T1 - Criteria for and Appropriateness of Renal Transplantation in Elderly Patients With End-Stage Renal Disease

T2 - A Literature Review and Position Statement on Behalf of the European Renal Association-European Dialysis and Transplant Association Descartes Working Group and European Renal Best Practice

AU - Segall, Liviu

AU - Nistor, Ionuţ

AU - Pascual, Julio

AU - Mucsi, Istvan

AU - Guirado, Lluis

AU - Higgins, Robert

AU - Van Laecke, Steven

AU - Oberbauer, Rainer

AU - Van Biesen, Wim

AU - Abramowicz, Daniel

AU - Gavrilovici, Cristina

AU - Farrington, Ken

AU - Covic, Adrian

PY - 2016/10/1

Y1 - 2016/10/1

N2 - During the last 20 years, waiting lists for renal transplantation (RT) have grown significantly older. However, elderly patients (ie ≥65 years of age) are still more rarely referred or accepted to waiting lists and, if enlisted, have less chances of actually receiving a kidney allograft, than younger counterparts. In this review, we looked at evidence for the benefits and risks of RT in the elderly trying to answer the following questions: Should RT be advocated for elderly patients? What should be the criteria to accept elderly patients on the waiting list for RT? What strategies might be used to increase the rate of RT in waitlisted elderly candidates? For selected elderly patients, RT was shown to be superior to dialysis in terms of patient survival. Virtually all guidelines recommend that patients should not be deemed ineligible for RT based on age alone, although a short life expectancy generally might preclude RT. Concerning the assessment of comorbidities in the elderly, special attention should be paid to cardiac evaluation and screening for malignancy. Comorbidity scores and frailty assessment scales might help the decision making on eligibility. Psychosocial issues should also be evaluated. To overcome the scarcity of organ donors, elderly RT candidates should be encouraged to consider expanded criteria donors and living donors, as alternatives to deceased standard criteria donors. It has been demonstrated that expanded criteria donor RT in patients 60 years or older is associated with higher survival rates than remaining on dialysis, whereas living donor RT is superior to all other options.

AB - During the last 20 years, waiting lists for renal transplantation (RT) have grown significantly older. However, elderly patients (ie ≥65 years of age) are still more rarely referred or accepted to waiting lists and, if enlisted, have less chances of actually receiving a kidney allograft, than younger counterparts. In this review, we looked at evidence for the benefits and risks of RT in the elderly trying to answer the following questions: Should RT be advocated for elderly patients? What should be the criteria to accept elderly patients on the waiting list for RT? What strategies might be used to increase the rate of RT in waitlisted elderly candidates? For selected elderly patients, RT was shown to be superior to dialysis in terms of patient survival. Virtually all guidelines recommend that patients should not be deemed ineligible for RT based on age alone, although a short life expectancy generally might preclude RT. Concerning the assessment of comorbidities in the elderly, special attention should be paid to cardiac evaluation and screening for malignancy. Comorbidity scores and frailty assessment scales might help the decision making on eligibility. Psychosocial issues should also be evaluated. To overcome the scarcity of organ donors, elderly RT candidates should be encouraged to consider expanded criteria donors and living donors, as alternatives to deceased standard criteria donors. It has been demonstrated that expanded criteria donor RT in patients 60 years or older is associated with higher survival rates than remaining on dialysis, whereas living donor RT is superior to all other options.

KW - Adult

KW - Aged

KW - Cardiovascular Diseases

KW - Frail Elderly

KW - Humans

KW - Kidney Failure, Chronic

KW - Kidney Transplantation

KW - Middle Aged

KW - Neoplasms

KW - Renal Dialysis

KW - Risk Reduction Behavior

KW - Journal Article

KW - Review

U2 - 10.1097/TP.0000000000001367

DO - 10.1097/TP.0000000000001367

M3 - Review article

C2 - 27472096

VL - 100

SP - e55-65

JO - Cell Transplantation

JF - Cell Transplantation

SN - 0963-6897

IS - 10

ER -