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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Dec 24, 2016; 6(4): 650-657
Published online Dec 24, 2016. doi: 10.5500/wjt.v6.i4.650
Older candidates for kidney transplantation: Who to refer and what to expect?
Beatrice P Concepcion, Rachel C Forbes, Heidi M Schaefer
Beatrice P Concepcion, Heidi M Schaefer, Department of Medicine, Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN 37232, United States
Rachel C Forbes, Department of Surgery, Division of Kidney and Pancreas Transplantation, Vanderbilt University Medical Center, Nashville, TN 37232, United States
Author contributions: All authors contributed significantly to the conception of the study, the acquisition, analysis and interpretation of data, drafting of the article and making critical revisions; all authors approved the final version of the article.
Conflict-of-interest statement: The authors have no potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Beatrice P Concepcion, MD, Assistant Professor of Medicine, Department of Medicine, Division of Nephrology and Hypertension, Vanderbilt University Medical Center, 1161 21st Avenue South, MCN S-3223, Nashville, TN 37232, United States. beatrice.p.concepcion@vanderbilt.edu
Telephone: +1-615-3226976 Fax: +1-615-3432605
Received: June 9, 2016
Peer-review started: June 14, 2016
First decision: July 11, 2016
Revised: July 29, 2016
Accepted: September 21, 2016
Article in press: September 23, 2016
Published online: December 24, 2016
Core Tip

Core tip: Transplant physicians must be well-versed in the intricacies of evaluating older kidney transplant candidates. This includes the appropriate selection of candidates which can be challenging due to the extent of comorbidity and frailty in this patient population. For patients who are deemed appropriate for transplant, physicians must be able to counsel them regarding expected outcomes and explain the expected benefit that transplantation confers over remaining on the deceased donor waiting list. Living donor kidney transplantation, even from older donors, should be encouraged. If no living donor is available, the rationale for accepting lesser quality kidneys should be discussed.