ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Abstract: SA-PO1075

Is Age Just a Number? Results of a Survey About Kidney Transplantation in Older Adults

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Liu, Christine, Stanford University, Stanford, California, United States
  • Basu, Arpita, Emory University, Atlanta, Georgia, United States
  • Farouk, Samira S., Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Hidalgo, Luis G., University of Wisconsin System, Madison, Wisconsin, United States
  • Lentine, Krista L., Saint Louis University, St. Louis, Missouri, United States
  • Malinis, Maricar, Vanderbilt University, Nashville, Tennessee, United States
  • Schaenman, Joanna, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Silski, Latifa, University of Cincinnati, Cincinnati, Ohio, United States
  • Bhalla, Anshul, The Permanente Medical Group Inc, Oakland, California, United States
  • Samra, Manpreet, University of Illinois Chicago, Chicago, Illinois, United States
Background

Over time, the number of older adults receiving kidney transplants has grown. Yet no guidelines exist regarding transplantation in older adults, including the use of age as an eligibility criterion. Our goal was to gather insights from transplant professionals about kidney transplantation in older adults.

Methods

An online survey was approved by the American Society of Transplantation (AST) Education Committee. Closed and open-ended questions were used, with some using Likert scale responses. The survey was sent out in December 2023 to the AST membership.

Results

Out of 110 respondents, 90% were physicians, 4% were advanced practice providers, and 4% were pharmacists. Most (73%) had been in practice for ≥ 5 years. The majority (84%) agreed that older persons benefit from transplant. When asked what age constituted “older,” 44% selected 70 years, while 38% chose 75 years (Figure). 77% disagreed with using age as an exclusion criterion. Instead, most (93%) agreed that frailty assessment should be part of the evaluation. Respondents commonly used the six minute walk, get up and go test, and/or the Fried frailty criteria. In addition to concerns about the greater burdens of cardiovascular disease and malignancy, over 90% of respondents shared that cognition and the presence of social support should also be part of the evaluation for older adults. 74% of respondents also agreed that older adults were at higher risk for infections post-transplant.

Conclusion

Most transplant professionals believe older adults benefit from kidney transplantation, with the majority considering 70+ years as “older.” Instead of age, transplant professionals endorse using frailty as part of transplant eligibility. Respondents also stated cognition, social support, and the greater infection risk should be considered in the evaluation of older adults for transplantation. Further efforts are needed to formalize guidelines for the evaluation of older adults for kidney transplantation.

Figure

Digital Object Identifier (DOI)