How Old Is Too Old To Have Knee Replacement
Not long ago there was widespread belief that total knee replacement surgery was for patients ages 60 to 75. This was a common age when people wore out their knee but they were still young enough to heal quickly after surgery.
More recently, the desire for older adults to be more active and not surrender to aging has seen younger people in the 45- 60 age group opt for knee replacement surgery .
Improved technology has allowed for patients who are older to receive TKR as well.
This article will focus on knee replacement for the elderly.
With improvements in anesthesia, general health care, and surgical techniques, knee replacement surgery has become widely accepted for elderly patients, including those over 80.
Osteoarthritis is the primary condition requiring knee replacement surgery, and it tends to get worse with age.
People are living longer and many of us want to remain active and have a good quality of life. There are many things to consider before we decide to have TKR, but its an even more important decision for patients over 80.
What Is A Kidney Transplant
Kidneys are vital organs that filter blood to remove waste, extra fluid, and salt from the body. If they stop working, it’s called kidney failure. Someone with kidney failure must go on or get a kidney transplant.
A kidney transplant is an operation where doctors put a new kidney in the body of someone whose own kidneys no longer work. One healthy kidney will do the work of two failed kidneys.
Because people can survive with just one kidney, a living person can give a healthy kidney to someone with kidney failure. This is called being a donor. A kidney also can come from a donor who has recently died, but the wait for this kind of donated kidney can take a year or more.
Most kidney transplants are successful. People who have kidney transplants will take medicines for the rest of their lives to prevent the body from rejecting the kidney. Rejecting means that the body’s immune cells destroy the new kidney because they sense that it’s foreign.
But aside from that, many kids and teens who have kidney transplants go on to live normal, healthy lives after they recover from surgery.
How Old Is Too Old
At many institutions, donors over the age of 60, 65, or even 70 are considered on a case-by-case basis.
Between 1990 and 2010, 219 people over the age of 70 donated kidneys, and researchers say the number of donors in this age group is on the rise.
Surgeons will make their decisions for this older group based on a potential donor’s health and how well their kidneys work. If you have high blood pressure, diabetes, or are overweight, you probably won’t qualify to be a donor. Even if you don’t have health complications, the surgeon who would operate on you would make the final decision on whether to allow you to donate a kidney.
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What Happens Before A Kidney Transplant
If your child needs a kidney transplant, your first step is to visit a transplant center. The health care team will check to make sure that your child is healthy enough to have surgery and take the medicines needed after the transplant. This will include blood tests, X-rays, and other tests, and can take a few weeks or months.
If the transplant team decides your child is a good candidate, the next step is to find a kidney. In most cases for living donor transplants, a kidney comes from a close relative or friend who has a compatible blood type.
If a living donor isn’t found, your child’s name will go on a waiting list until a kidney from a deceased donor is matched to your child. The need for new kidneys is far greater than the number donated, so this can take a long time.
You’ll stay in close touch with the doctors and the rest of the health care team. Make sure they know how to reach you at all times. When a kidney is located, you’ll need to go to the transplant center at a moment’s notice.
While you wait for a transplant, keep your child as healthy as possible. That way, he or she will be ready for transplant surgery when the time comes. Help your child:
- eat healthy foods and follow any special diet recommendations from the doctor, nurse, or dietitian
- take all medicines as directed
- keep all medical appointments
Tell your doctor and the transplant center right away if is any change in your child’s health.
How Is My Child Placed On The Waiting List For A New Kidney
Talk with your childs healthcare team to see if a transplant is an option for your child. If it is, then have your childs provider refer you to a transplant center in your area. Transplant centers are located in certain hospitals throughout the U.S. Your child must complete a full evaluation at the transplant center.
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Frequently Asked Questions About Kidney Transplant Evaluation And Listing
If your kidneys have stopped working properly, or may stop working soon, you have what is called end-stage kidney failure. There are a number of choices you can make. You will need to decide what medical treatment is best for you. Your doctor, patient support groups, and other people who have been treated for kidney disease can give you more information to help you. The more you learn, the better you may feel about your decision.
The two common options for treating end-stage kidney failure are dialysis and kidney transplantation. Either choice is a treatment, not a cure. Either option will involve ongoing medical care to keep you healthy. Some people will do better with one form of treatment than the other.
The following questions and answers can help you learn more about whether transplantation may be a good choice for you.
What Happens After A Kidney Transplant
After kidney transplant surgery, your child will spend a few days in the hospital to recover. The health care team will watch closely to make sure there are no complications from the surgery, such as bleeding or infection.
You and your child will learn about the medicines needed to keep the body from rejecting the new kidney. These are called immunosuppressants. Taking them can make your child more likely to get infections, especially in the days right after surgery. So keep your child away from sick people, and have everyone at home wash their hands well and often.
For the first couple of months after surgery, you’ll see the doctor often to make sure the new kidney is working well. If your child gets a fever or soreness in the area of the transplant, tell a doctor right away. These could be signs that the body isn’t accepting the new kidney or that your child has an infection.
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How Can I Get More Information
A kidney transplant program will have detailed information about their evaluation process and their criteria for accepting transplant candidates. To locate a kidney transplant program closest to you: Search membership
The toll-free patient services line of the Organ Procurement and Transplantation Network can provide information about the OPTN, allocation policy and other resources available to you, in both English and Spanish. Additional information is available online on the following websites:
Survival Of Patients Placed On The Transplantation Waitlist
Among patients remaining on the transplantation waitlist , median survival from waitlisting was 3.4 years compared to 4.8 years in the transplant group . Five-year survival was 31% among waitlisted patients and 49% in transplant recipients . In the time-dependent Cox model, we found no significant difference between the transplant and waitlist groups, even though there was a trend towards an overall reduced risk of death for those who were transplanted hazard ratio 0.78, 95% confidence interval 0.521.18, P = 0.25 . The variables identified as significant/near significant risk factors for acute rejection episodes were immunosuppression with AZA versus MMF odds ratio 2.79, 95% CI 1.565.38, P = 0.002, any HLA-DR mismatch OR 2.04, 95% CI 1.113.78, P = 0.023, donor age over 60 years OR 2.05, 95% CI 1.093.86, P = 0.025 and cytomegalovirus positive donor OR 2.11, 95% CI 0.984.57, P = 0.058. The following other variables were also tested in the multivariate logistic regression model without significant impact: recipient age, living versus deceased donor, panel reactive antibody positive recipient, any HLA-A mismatch, any HLA-B mismatch and cold ischemia time.
KaplanMeier survival plot: survival of waitlisted patients and patients receiving a kidney transplant. Start of dialysis: 19902005. Patients were censored from the waitlist group at the time of transplantation.
How Old Is Too Old To Have A Kidney Transplanted
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What Is Total Joint Replacement
When someone talks about getting a hip or knee replacement, theyre probably referring to total joint replacement surgery.
Surgeons perform total joint replacements on many joints, but hips and knees are the most common. During total joint replacement, an orthopedic surgeon removes the damaged cartilage. Then, they replace the damaged sections of the joint with specialized metal, plastic or ceramic parts.
This surgery relieves symptoms of osteoarthritis , which is the most common type of arthritis. OA happens when the cartilage inside a joint breaks down. Cartilage is the smooth material that cushions your joints. When it wears down over time, it causes pain, swelling and stiffness.
The new joint allows you to move without the pain and stiffness of OA.
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What Are The Different Types Of Kidney Transplants
There are two kinds of kidney transplants depending on who donates the new kidney.
A living-donor transplant is when someone gets a kidney from a person who is still alive and well. It’s usually from a relative or close friend, but sometimes strangers donate.
A is when people donate their kidneys for transplant after they die. This requires people who need kidneys to put their names on a waiting list until a donor is found.
The Tyranny Of Potential
The potential of avoiding death and prolonging later life through clinical technique looms large in US aging society as a biomedical project, an individual aspiration, a public policy challenge, and a societal goal. Clinical medicine materializes that potential in its therapies and in its discourse about therapies that offer, for ever-older individuals, additional months or years of life. The cultural work of potentiality is carried out in clinical encounters whenever treatment strategies about life extension are discussed. That cultural work is evident in the ways future thinking is embedded in clinical rationality . Because of the growing elderly population, because those over age 85 years constitute the fastest growing segment of all, and because living beyond 85 now seems normal for many, the problem and promise of greater longevity has become a major site at which potentiality comes to rest in US clinical contexts. The problem with the practice and success of organ transplantation at older ages is that it supports and feeds the ideas of limitless medical progress, ever-fixable bodies, and open-ended life extension that have become part of the fabric of social life in the United States and other locations . In the pursuit of that potential, age has become a central cause of scarcity, and it has contributed to new expressions of obligation, altruism, actuarial science, debt, and self-interest.
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What Are The Risks Of Kidney Transplant
The risks of kidney transplantation are the same as those of any surgery. There is the risk of bleeding, infection or breathing problems. You also might experience some side effects from the medications, and you could be more prone to infections since the medicine you will take after transplantation lowers your body’s ability to fight infection.
Kidney transplant rejection
Since your body recognizes the new kidney as a foreign object, it will normally try to get rid of it or “reject” it. However, youll be given medicine to prevent rejection.
Because of years of experience, research, and improved medicines that prevent rejection, kidney transplants are very successful with few complications after transplantation.
How Old Is Too Old For Hip Or Knee Replacement
More people are reaching their 80s and 90s, and many of them lead active lives, says Dr. Piuzzi. So were seeing more people in these age groups who want relief from hip or knee pain.
Total joint replacement is major surgery and requires several weeks of recovery at home. But despite this, youre never too old to have your hip or knee replaced.
There is no age cutoff for joint replacement, says Dr. Piuzzi. Studies have found that people in their 80s and 90s benefit from hip or knee replacement as much as younger people.
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How Does A Kidney Transplant Differ From Dialysis
With dialysis treatment, a machine filters waste and extra fluid out of your blood the way your kidneys normally would. Many people undergo dialysis while awaiting a kidney transplant.
Dialysis only filters the blood during a treatment session, not in the constant way a kidney does. For this reason, dialysis patients usually have diet and fluid restrictions. Dialysis also requires an access site a vein or an implanted device where the blood can be collected and filtered outside the body.
A kidney transplant is a surgical operation to give a functioning human kidney to someone whose kidneys have stopped working or are close to failing. The functioning kidney is removed from either a living donor or someone who has recently passed away.
A transplanted kidney performs all the functions of a kidney a person has from birth. It constantly filters blood for waste and excess fluid. Most kidney transplant recipients do not have to limit their diet and fluid intake, but they do need to take medicine on a daily basis to help keep their transplant functioning.
The Elderly And Mortality
In elderly the most important reason for late allograft loss is death with a functioning graft . In a large registry using UNOS and USRDS data, Ojo et al. found that 42,5% of graft loss was due to DWFG. Age at transplantation was an obvious, strong and independent risk factor. When compared to those aged 1829 years, recipients aged over 65 years had a 7-fold increased risk to die with a functioning graft. Besides age, ESRD caused by systemic vascular diseases such as hypertension or diabetes mellitus was an independent risk factor for premature death . This was confirmed in a study of El-Zoghby et al. where 43.4% of the grafts were lost due to death. Interestingly, the most important cause of death more than 5 years after transplantation was due to infectious causes. Transplant recipients who died due to infections were older as compared to those due to cardiovascular diseases. This observation supports the fact that elderly kidney transplant recipients are an already highly selected group with excess infectious comorbidity and mortality, the downside of current potent clinical immunosuppressive drugs, and therefore a key consideration comparable to the increased cardiovascular risk in younger recipients .
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Here Are Some Common Questions Relating To Deceased Donor Transplants
HOW WOULD I BE MATCHED FOR A KIDNEY FROM A DECEASED DONOR?
The computer database of the Organ Procurement and Transplantation Network matches medical information on all transplant candidates who are actively listed on the waitlist nationwide with medical information on deceased donors. The database produces a rank-ordered list for each donor offer that determines who will be offered the kidney.
When a transplant team gets an organ offer for one of its patients, it reviews detailed medical information about the donor. The team will then decide whether to accept the offer for their candidate. If the offer is turned down for one candidate, it goes to the next person on the list.
Kidneys that are likely to function for the longest amount of time are considered first for candidates who are likely to need them the longest. Other factors in matching include how closely the donors blood and tissue type matches the patient, how long the candidate has needed a kidney transplant, and how close the transplant hospital is to the donor hospital.
HOW LONG IS THE WAIT FOR A DECEASED DONOR TRANSPLANT?
WHAT MUST I DO AFTER A TRANSPLANT?
A transplant is a treatment for kidney failure, not a cure. After a transplant, you will need ongoing treatment to stay healthy and keep your kidney working well.
What Happens During A Kidney Transplant Procedure
Kidney transplantation involves placing a healthy kidney into your body, where it can perform all of the functions that a failing kidney cannot.
Your new kidney is placed on the lower right or left side of your abdomen where its surgically connected to nearby blood vessels. Placing the kidney in this position allows it to be easily connected to blood vessels and your bladder. The vein and artery of your new kidney are attached to your vein and artery. The new kidney’s ureter is attached to your bladder to allow urine to pass out of your body.
What happens to my old kidneys?
In most cases, your surgeon will leave your diseased kidneys inside your body. However, there are three conditions that might require the removal of your old kidneys:
- Infection that could spread to your new, transplanted kidney.
- Unmanaged or uncontrollable high blood pressure caused by your original kidneys.
- Reflux or a backup of pee into your kidneys.
How long is kidney transplant surgery?
On average, kidney transplant surgery takes two to four hours to complete.
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