The authors urge clinicians to encourage elderly patients with kidney disease to consider transplantation over other forms of treatment. "Early engagement and education of patients and their families about the benefits and opportunities for transplantation may lead to further increases in the use of transplantation in this age group. Policy changes and research are also needed to further expand access to transplantation in the elderly," they wrote.

In reviewing the results of this study in an accompanying editorial, Suphamai Bunnapradist, MD and Gabriel Danovitch, MD (David Geffen School of Medicine at the University of California, Los Angeles) noted that elderly patients' probability of receiving a transplant in the latter part of the study period remained quite small and that barriers to transplantation are more pronounced in elderly candidates. "Practitioners should consider in a careful and compassionate manner whether transplantation is a realistic option for each elderly end-stage renal disease candidate," they wrote. "Each transplant program must carefully consider the most cost-effective and clinically rational manner in which their elderly candidates are evaluated and managed while on the waiting list."

SOURCE Clinical Journal of the American Society of Nephrology