The Journey of Transplantation – Considerations for Older Adults

Kristin Fischer, MSW from Sanford Health Transplant Center

Developing end-stage organ disease at an older age doesn’t have to be as devastating as it once would have been.  Progress in surgical technique, medications, and transplant care has led to a dramatic increase in the number of older individuals who are able to successfully undergo organ transplantation and live a longer and healthier life.  For example, from 1999 to 2008 there was a 300% increase in kidney recipients over the age of 65.

In many instances, chronological age itself is no longer the determining factor in someone’s suitability to receive an organ transplant.  But many factors go into considering whether or not transplant is a realistic option for each older transplant candidate.
It is possible that other health conditions will make it too risky for you to undergo such an extensive surgery, or to alter your immune system’s ability to fight infection.  As with anyone considering transplantation, older people need to undergo an extensive evaluation to determine if you are eligible and/or appropriate to have a transplant.  This evaluation includes assessment of and discussion about various issues, including (but not limited to) your:

  • Health status
  • Social support
  • Activity level
  • Financial status
  • Potential recovery time/Possible complications
  • Donor source (living or deceased donor; ideal donor age)

Though it’s become more common and more successful in the older population, organ transplantation is not always an easy road.  Transplantation is a treatment option, not a cure.  For persons of any age in the journey of an organ transplant, the evaluation and surgery are only the beginning.  Having a transplant means committing to taking immunosuppression medications (medicines that keep your body’s immune system from attacking the transplanted organ) every day for the rest of your life, and following a specific routine of follow-up care.  The risks and benefits (medically, psychologically, socially and financially) must be taken into consideration. The goal of transplantation is always to improve or maintain your quality of life.

One of the most important things to keep in mind for older persons considering transplantation is to think of this treatment option within the framework of what you want for the rest of your life.  Talk with your Transplant Team and your family about your goals, fears, and needs for the future, and whether or not a transplant will make you more or less likely to realize them.  If your recovery from surgery doesn’t go as planned, how would you feel about having to receive daily help from friends or family, or even go to a nursing home for a period of time?  Would possibly losing some independence during the recovery period be worth it if the transplant worked? Would the costs associated with transplant prevent you from having the money to complete some other things on your “bucket list”?  How would taking daily medications to prevent organ rejection (and dealing with any potential side effects) impact your day-to-day life and routine?
There are things you can do to increase the likelihood that you can be a transplant candidate at an older age:

  •  Maintain your overall health – visit your primary physician routinely and remain up-to-date on all routine health screenings.
  • Stay physically active – this will improve your overall health and may make the recovery process easier and quicker.
  • Talk openly with your family and your doctors about your interest in transplant and your goals for the remainder of your life.  Think about how transplant may fit into those goals, and what you can do to help make a transplant more successful.