Meeting Report
Solid-Organ Transplantation in Older Adults: Current Status and Future Research

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An increasing number of patients older than 65 years are referred for and have access to organ transplantation, and an increasing number of older adults are donating organs. Although short-term outcomes are similar in older versus younger transplant recipients, older donor or recipient age is associated with inferior long-term outcomes. However, age is often a proxy for other factors that might predict poor outcomes more strongly and better identify patients at risk for adverse events. Approaches to transplantation in older adults vary across programs, but despite recent gains in access and the increased use of marginal organs, older patients remain less likely than other groups to receive a transplant, and those who do are highly selected. Moreover, few studies have addressed geriatric issues in transplant patient selection or management, or the implications on health span and disability when patients age to late life with a transplanted organ. This paper summarizes a recent trans-disciplinary workshop held by ASP, in collaboration with NHLBI, NIA, NIAID, NIDDK and AGS, to address issues related to kidney, liver, lung, or heart transplantation in older adults and to propose a research agenda in these areas.

Key words:

Aging
elderly
heart
kidney
liver
lung
transplantation

Abbreviations:

AGS
American Geriatrics Society
ASA
American Society of Anesthesiologists
ASP
Association of Specialty Professors
CVD
cardiovascular disease
ECD
expanded criteria donor
ESRD
end-stage renal disease
HRQOL
health-related quality of life
IPF
idiopathic pulmonary fibrosis
MELD
model for end-stage liver disease
NHLBI
National Heart, Lung and Blood Institute
NIA
National Institute on Aging
NIAID
National Institute of Allergy and Infectious Diseases
NIDDK
National Institute of Diabetes and Digestive and Kidney Diseases
QALYS
quality-adjusted life-year saved

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