Singh Neeraj, Nori Uday, Pesavento Todd
Division of Transplantation, Department of Nephrology, The Ohio State University Medical Center, Columbus, Ohio 43210, USA.
Curr Opin Organ Transplant. 2009 Aug;14(4):380-5. doi: 10.1097/mot.0b013e32832dbd06.
Recent outcome data, ongoing organ shortage and proposed changes in allocation policies are driving the need to review current practices and possible future course of kidney transplantation in the elderly patients.
A proposed new kidney allocation system based on matching donor and recipient characteristics to enable 'age-matched' kidney allocation is currently being discussed in the USA. While this system benefits younger recipients, implications for elderly recipients receiving older grafts remain a matter of debate.
Despite improved outcomes, there remain significant challenges to kidney transplantation in the elderly, including organ shortage, poor transplant rate, evolving allocation policies, high wait-list mortality and nonstandardized immunosuppression. Prospective studies are needed to evaluate the strategies to meet these challenges and to study the impact of proposed new allocation system.
近期的结果数据、持续的器官短缺以及分配政策的拟议变化，促使有必要审视老年患者肾移植的当前做法和未来可能的发展方向。
美国目前正在讨论一种基于供体和受体特征匹配以实现“年龄匹配”肾脏分配的新肾脏分配系统。虽然该系统使年轻受体受益，但老年受体接受老年供肾的影响仍存在争议。
尽管结果有所改善，但老年患者肾移植仍面临重大挑战，包括器官短缺、移植率低、分配政策不断演变、等待名单死亡率高以及免疫抑制不规范。需要进行前瞻性研究以评估应对这些挑战的策略，并研究拟议的新分配系统的影响。
