Can We Solve the Discrepancy Between Demand and Supply

Wednesday July 04, 2018 from 14:30 to 16:00

Room: N-103

562.2 The challenges of older donors and recipients

Stefan G. Tullius, United States

Chief, Division of Transplant Surgery; Professor of Surgery, Harvard Medical School
Brigham & Women's Hospital


As the discrepancy between demand and supply in organ transplantation continues to increase, organs that have previously not been accepted for transplantation need to be considered. Older organs may not only have an inferior quality, they also have a compromised repair capacity. Moreover, the transplantation of older organs has been linked to augmented alloimmune responses. Nevertheless, older organs can be successfully used for transplantation in selected patients. Novel preservation methods and treatments may be particularly relevant for older organs allowing the assessment of organ quality and potentially help repairing injury.

Older recipients appear particularly prone in accumulating co-morbidities while waiting for a transplant. Thus, transplanting older patients early even with a less than optimal (older) organ appears advantageous. Traditionally, older transplant recipients have been excluded from immunosuppressive trials. Notably, immunosuppressants, appear to work differently in older recipients necessitating not only different dosages but also considering an age-specific immunosuppression.

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