Solid organ transplantation: Technical progress meets human dignity a review of the literature considering elderly patients’ health related quality of life following transplantation

IntroductionMany transplant studies in elderly patients focus on survival and mortality rates. It was the aim of this review to evaluate publications dealing with individual patient performance and independence.MethodsThe literature search included all articles retrievable for the hit “transplantation in elderly recipients” between 1960 and 2010. For quality search the inclusion criteria were as follows: older than 60 years and transplanted kidney, liver, heart, lung or pancreas from a deceased or living donor. We focussed on parameters concerning quality of life, frailty, nutritional status/weight loss, drugs/interactions/polypharmacy, gait/osteoporosis/fracture, delirium/dementia and geriatric assessment to address physical and psychosocial functionality of elderly recipients.ResultsThe initial hit list contained 1427 citations from electronic databases. 249 abstracts thereof were selected for full review. A total of 60 articles met final inclusion criteria. Finally, only five studies met the qualitative inclusion criteria as listed above.ConclusionThe number of elderly patients placed on waiting lists has increased dramatically and will further grow. Interdisciplinary collaboration and distinct patient selection is recommended in most of the studies. However, data concerning quality of life and related parameters in elderly transplant recipients are rare.

► The number of studies on the transplantion of elderly people is limited and only focused on survival.
► Only 5 out of 1427 studies dealt with the special needs of this patient polulation.
► We evaluated those 5 studies regarding their accuracy concerning elderly patients.
► We found out, that even in those studies quality of life was only of inferior importance.