Organ Transplant Recipients, Donors Aging

portal-graphics-20_1156382aAs the population ages, a new trend is emerging in organ transplantation:  Donors and recipients are also getting older.  Recently, an 84-year-old Chicago man was given the kidney of a 69-year-old donor,  illustrating this trend in transplant medicine.  Americans 60 and up are the fastest-growing age group on transplant waiting lists; concurrently, kidneys are more frequently being accepted from older donors.

Medical bioethicists are concerned that using less-than-perfect kidneys for transplant is too risky and urge full disclosure to the recipients.  The disadvantage of using older kidneys is a higher likelihood of organ rejection and death.

The transplant waiting list is aging as people live longer and develop diseases such as diabetes and hypertension that can lead to end-stage renal failure.  Patients willing to accept an expanded-criteria kidney wait less time for an organ and are less likely to die than patients on dialysis.  The average wait for a kidney in Illinois is five years.  Approximately half of kidney transplant patients older than 60 die before getting a deceased-donor organ, according to a recent study published in the Clinical Journal of the American Society of Nephrology.

“The primary reason (for using these kidneys) is to try to get the most out of the existing organs to save lives, but another factor is that transplantation is lucrative,” said Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania.  “We have a lot of programs doing transplants, clearly more than the supply of organs justify.  That means people want to save lives but they also push hard to use organs of somewhat questionable quality.  An 84-year-old needs to know that (surgeons) are talking about a kidney that they had reservations about.”

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