Forty-six percent of patients over age 60 currently on the waiting list for a kidney transplant will die before they receive an organ from a deceased donor, reports an upcoming study in the Clinical Journal of the American Society of Nephrology (CJASN). "Our results emphasize the particular need to consider living donation as an alternative source for some older patients—or alternatively, the critical importance of navigating the steps to receive a deceased donor transplant as rapidly as possible," comments Jesse D. Schold, PhD (University of Florida, Gainesville).
The researchers analyzed data on nearly 55,000 patients over age 60 that were placed on the U.S. waiting list for a kidney transplant from 1995 to 2007. Projections suggested that 46 percent of patients wait-listed in 2006-07 would die before receiving a deceased-donor transplant.
Certain groups were at even higher risk of death before acquiring a kidney, including African Americans and patients aged 70 or older. Medical factors like blood type and being on dialysis at the time of listing also affected risk. The study found wide variations between different transplant regions as well.
The need for kidney transplantation is increasing while donor rates remain stable, leading to longer waiting times and increased rates of death on the waiting list. "We have now reached a notable benchmark in which nearly half of newly listed older candidates will not survive the interval to receive a deceased donor transplant," according to Dr. Schold.
The results will help provide patients with specific information on their chances of receiving a transplant, based on factors like, age, race, and transplant region, in addition to their medical status. "Patients and their caregivers should understand their specific circumstances in their decision-making process," Dr. Schold adds.
While the population-based study illustrates many important factors associated with survival in older patients awaiting kidney transplantation, it may lack information on some of the many other variables that can affect prognosis.
The study authors reported no financial disclosures.
The study will appear online at http://jasn.asnjournals.org/ on Thursday, June 18, 2009, doi 10.2215/CJN.01280209.
Founded in 1966, the American Society of Nephrology (ASN) is the world's largest professional society devoted to the study of kidney disease. Comprised of 11,000 physicians and scientists, ASN continues to promote expert patient care, to advance medical research, and to educate the renal community. ASN also informs policymakers about issues of importance to kidney doctors and their patients. ASN funds research, and through its world-renowned meetings and first-class publications, disseminates information and educational tools that empower physicians.
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