Half of Seniors on Kidney Transplant List May Die

Those older than 60 likely to die before deceased-donor kidney becomes available

20 june 2009-- Nearly half of the patients older than 60 waiting for a kidney transplant from a deceased donor will die while on the waiting list, according to a study published online June 18 in the Clinical Journal of the American Society of Nephrology.

Jesse Schold, M.D., of the University of Florida in Gainesville, and colleagues analyzed data from the national Scientific Registry of Transplant Recipients on 54,669 kidney transplant candidates who were older than 60 in the years 1995 to 2007. The researchers estimated the time to deceased-donor transplantation and mortality after candidate listing.

The analysis found that 46 percent of candidates in this group will likely die before a kidney becomes available from a deceased donor. The mortality rate was further elevated for several common subgroups: blood type B (71 percent), highly sensitized (68 percent), African American (62 percent), diabetes (61 percent), blood type O (60 percent), on dialysis when listed (53 percent), and age of 70 or older (52 percent). There also was pronounced variation in mortality for different regions of the United Network for Organ Sharing, which ranged from 6 to 81 percent.

"These data highlight the prominent and growing challenge facing the field of kidney transplantation. Older candidates are now at significant risk for not surviving the interval in which a deceased-donor transplant would become available. Importantly, this risk is variable within this population, and specific information should be disseminated to patients and caregivers to facilitate informed decision making and potential incentives to seek living donors," the authors conclude.

Abstract
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