That is why such experts as Kapur, Segev and Mikel Prieto, surgical director of the kidney and pancreas transplant program at the Mayo Clinic in Rochester, Minn., are trying to broaden the pool of potential living donors to include adults in their 60s and 70s.
Studies indicate that 10 to 20 percent of seniors who need a transplant would find living donors, many of them among people of their own age, if they looked, Segev said.
But many doctors don’t believe this is a reasonable option, and many patients don’t believe they could be good candidates.
Although older kidney donors haven’t been studied extensively, a handful of reports suggest that this surgery is safe and complications are relatively uncommon when donors are carefully selected.
“It’s very common that patients in their 70s want to donate. It’s less common that they are fit to donate,” said Prieto. Anyone with a history of heart disease, stroke, diabetes, cancer, cognitive impairment and several other conditions common in older people are excluded from donation. Often, a host of minor medical issues that might seem insignificant individually will also disqualify a prospective elderly organ donor, he noted.
‘A good decision’
Like Robert Brown and his wife, Shirley Hall and her brother-in-law Hilding “Joe” Johansson did not see age as an impediment to transplant surgery. Hall, who divides her time between Howard, S.D., and Apache Junction, Ariz., is 75. Johansson, of Sioux Falls, S.D., is 71.
Johansson has polycystic kidney disease, and over 15 years he had two operations to remove growths on his kidneys.
After donating a kidney to Johansson at the Mayo Clinic last fall, Hall felt “a little bit of pain” but not enough to take the medication doctors ordered. Several months later, she said, “I’m feeling great.” Johansson said he has a lot more energy and is looking forward to traveling and bow hunting in the year ahead.
After his September 2010, surgery at Johns Hopkins, Robert Brown developed an infection at an abdominal incision made to remove his kidney. But it responded to topical treatments, and several weeks later he began exercising again.
Sue Brown’s post-transplant medication regimen made her “unbalanced” and “lightheaded” and it had to be adjusted over the course of several months, but looking back over the experience, she said she was convinced that it was a “good decision.”
“We’re taking great care of each other, and I appreciate that,” she reflected, noting that their 50th wedding anniversary is coming up this year. “For one thing, I know he loves me and enjoys being with me and doesn’t want to get rid of me.”
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.