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Erschienen in: Zeitschrift für Gerontologie und Geriatrie 6/2016

01.08.2016 | Beiträge zum Themenschwerpunkt

Nierentransplantation im Alter

verfasst von: Prof. Dr. C. Kurschat

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 6/2016

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Zusammenfassung

Ältere Patienten profitieren trotz vielfältiger Komorbiditäten und Komplikationen von einer Nierentransplantation, insbesondere im Hinblick auf ihre Lebenserwartung. Patienten gleichen Alters an der Dialyse sterben im Durchschnitt früher als Patienten, die nierentransplantiert werden. Zusätzlich erleben transplantierte Patienten eine deutliche Verbesserung ihrer Lebensqualität. Allerdings ist im Einzelfall kritisch abzuwägen, ob eine Nierentransplantation für den individuellen Patienten sinnvoll ist. Hier ist der Einsatz geriatrischer Bewertungsmethoden wichtig, um die Belastbarkeit eines Patienten abzuschätzen. Damit die Wartezeit für die Patienten und auch die kalte Ischämiezeit der Nieren deutlich verkürzt werden können, startete 1999 das Eurotransplant-Senior-Programm (ESP oder „old for old“). In diesem Programm werden Nieren von älteren Spendern (ab 65 Jahren) lokal an ältere Empfänger (ab 65 Jahren) vermittelt. Die Ergebnisse im ESP sind dahingehend vielversprechend, dass dieses Programm älteren Empfängern schneller zu einer Transplantatniere verhelfen kann. Insgesamt ist allerdings die Lebendnierenspende eine sinnvolle Alternative zum ESP, sofern ein geeigneter Spender zur Verfügung steht. Eine Altersgrenze für die Evaluation eines potenziellen Spenders existiert nicht. Die bei einer Lebendnierenspende transplantierten Nieren haben eine längere Funktionszeit und eine höhere Spontanfunktionsrate im Vergleich zu einer Verstorbenenspende und bieten daher einen deutlichen Vorteil für den älteren Empfänger.
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Metadaten
Titel
Nierentransplantation im Alter
verfasst von
Prof. Dr. C. Kurschat
Publikationsdatum
01.08.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 6/2016
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-016-1118-x

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