Is there something special about immunology in elderly grafts/recipients?
In 1995, Cecka et al. noted that kidneys from donors older than 60 years had a bad outcome particularly in immunized recipients (>10% HLA antibodies). One‐year graft survival was 60% compared to 80% when the donor age was 19–30 years. In the case of a rejection episode during initial hospitalization, 53% of all elderly grafts functioned at 1 year as compared to 71% of the organs from younger donors. One explanation for these results is a diminished functional reserve of elderly organs, producing a more pronounced detrimental effect in structural damage. It is widely accepted that the immune system, and thus the immune response, become impaired with age [49]. Many studies have demonstrated that functional and phenotypic changes occur in T lymphocytes with age, while the production of cytokines in response to T‐cell activation is altered and changes in macrophage activity may be partially responsible for cellular and humoral immunodeficiency in the elderly. Consequently, the incidence an
