Thousands of seniors lack access to lifesaving organs, despite survival benefit

January 12, 2012, Johns Hopkins Medical Institutions

Thousands more American senior citizens with kidney disease are good candidates for transplants and could get them if physicians would get past outdated medical biases and put them on transplant waiting lists, according to a new study by Johns Hopkins researchers.

The Hopkins investigators estimate that between 1999 and 2006, roughly 9,000 adults over 65 would have been "excellent" and approximately 40,000 more 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 transplant, but many of them are if they are carefully selected and if factors that really predict outcomes are fully accounted for," says Dorry L. Segev, M.D., Ph.D., 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 . "Many older adults can enjoy excellent transplant outcomes in this day and age," he says, 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, Segev says. The trouble is, he adds, that very few older adults are even put on transplant waiting lists. In 2007, only 10.4 percent of dialysis patients between the ages of 65 and 74 were on waiting lists, compared to 33.5 percent of 18- to 44-year-old dialysis patients and 21.9 percent of 45- to 64-year-old .

Segev cautions that some older patients are indeed poor transplant prospects, because they have other age-related health problems. But he says his team's new findings, in addition to other recent research, show that new organs can greatly improve survival even in this age group.

Segev and his team constructed a statistical model for predicting how well older adults would be expected to do after kidney transplantation by taking into account age, smoking, diabetes and 16 other health-related variables. Using those data to define an "excellent" candidate, the information was then applied to every person 65 and older on dialysis during the seven-year study period. The researchers also determined whether these candidates were already on the waiting list.

"We have this regressive attitude toward transplantation in older adults," Segev says, "one based on historical poor outcomes in older patients, which no longer hold up. Anyone who can benefit from kidney transplantation should at least be given a chance. They should at least be put on the list."

Segev says he knows there is a shortage of kidneys and some will question whether scarce organs would be put to better use in younger patients. But Segev's study predicts that more than 10 percent of older patients would get kidneys from living relatives or friends, which would have little impact on the nationwide shortage of deceased donor kidneys. But finding a living donor first requires referral for transplantation.

"By not referring older adults for , we're not just denying them a chance at a kidney from a deceased donor, but we're potentially denying them a kidney from a live donor," he adds.

According to research by Segev and his team published last year in the Journal of the American Medical Association, live kidney donation is very safe for both donor and recipient, and more older adults are donating their kidneys to relatives. Other research done by Segev has shown that older recipients do well with kidneys from older donors, organs that are otherwise be rejected for use in younger .

Explore further: Never too old to donate a kidney?

Related Stories

Never too old to donate a kidney?

October 28, 2011
People over age 70 years of age can safely donate a kidney, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN). The results provide good news for patients ...

Recommended for you

Best of Last Year—The top Medical Xpress articles of 2017

December 20, 2017
It was a good year for medical research as a team at the German center for Neurodegenerative Diseases, Magdeburg, found that dancing can reverse the signs of aging in the brain. Any exercise helps, the team found, but dancing ...

Pickled in 'cognac', Chopin's heart gives up its secrets

November 26, 2017
The heart of Frederic Chopin, among the world's most cherished musical virtuosos, may finally have given up the cause of his untimely death.

Sugar industry withheld evidence of sucrose's health effects nearly 50 years ago

November 21, 2017
A U.S. sugar industry trade group appears to have pulled the plug on a study that was producing animal evidence linking sucrose to disease nearly 50 years ago, researchers argue in a paper publishing on November 21 in the ...

Female researchers pay more attention to sex and gender in medicine

November 7, 2017
When women participate in a medical research paper, that research is more likely to take into account the differences between the way men and women react to diseases and treatments, according to a new study by Stanford researchers.

Drug therapy from lethal bacteria could reduce kidney transplant rejection

August 3, 2017
An experimental treatment derived from a potentially deadly microorganism may provide lifesaving help for kidney transplant patients, according to an international study led by investigators at Cedars-Sinai.

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.