{"id":2961,"date":"2026-09-13T08:42:58","date_gmt":"2026-09-13T08:42:58","guid":{"rendered":"https:\/\/bookinghospital.org\/?p=2961"},"modified":"2026-09-13T08:55:12","modified_gmt":"2026-09-13T08:55:12","slug":"kidney-transplant-age-weight-second-transplant","status":"publish","type":"post","link":"https:\/\/bookinghospital.org\/ro\/kidney-transplant-age-weight-second-transplant\/","title":{"rendered":"Too Old, Too Heavy, or Already Had One? Kidney Transplant Limits"},"content":{"rendered":"<div data-elementor-type=\"wp-post\" data-elementor-id=\"2961\" class=\"elementor elementor-2961\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d2e5c9d e-con-full e-flex e-con e-parent\" data-id=\"d2e5c9d\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-42b93c4 elementor-widget elementor-widget-html\" data-id=\"42b93c4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div id=\"bh\">\n\n<section class=\"hero\">\n  <div class=\"in\">\n    <p class=\"eyebrow\">Kidney transplantation \u00b7 Who can receive<\/p>\n    <h1>Told you are too old, too heavy, or that your first transplant was your only chance?<\/h1>\n    <p class=\"lead\">These are three of the most common reasons patients are turned away. Only one\n       of them is ever a firm line \u2014 and even that one can usually be moved.<\/p>\n    <p class=\"meta\">Written by <b style=\"color:#fff\">Profesorul Dr. Murat Tuncer<\/b> \u00b7\n       Adapted from his book <i>Kidney Transplantation \u2014 With Questions and Answers<\/i><\/p>\n  <\/div>\n<\/section>\n\n<section class=\"wrap\">\n\n  <div class=\"ozet\">\n    <h2>The short answer<\/h2>\n    <ul>\n      <li><b>Age:<\/b> most transplant centres set <b>no upper age limit<\/b>. Over 70, the tests\n          are more thorough \u2014 but age alone does not rule you out.<\/li>\n      <li><b>Weight:<\/b> a body mass index (BMI) of <b>40 or above<\/b> is the line. The target is\n          below 30, and patients are helped to get there.<\/li>\n      <li><b>Being too thin matters too.<\/b> A BMI below 20 is linked to infection and slower\n          wound healing.<\/li>\n      <li><b>Second transplant:<\/b> a failed first kidney is <b>not the end<\/b>. If it lasted more\n          than four years, the second has an <b>84%<\/b> chance of working at three years.<\/li>\n    <\/ul>\n  <\/div>\n\n  <h2>\"You are too old for a transplant\"<\/h2>\n\n  <p>Most transplant centres do not set a fixed age limit. Patients are judged on their\n     <b>suitability for transplantation, not on their birth year<\/b>.<\/p>\n\n  <p>What does change after 70 is how carefully the team looks. This is not because doctors\n     think a kidney given to an older patient is \"wasted\". There are two real reasons:<\/p>\n\n  <ul>\n    <li>An older body may have more difficulty <b>tolerating the operation itself<\/b>.<\/li>\n    <li>The medicines that stop the body rejecting the new kidney can be <b>heavier to carry<\/b>\n        at that age.<\/li>\n  <\/ul>\n\n  <div class=\"box\">\n    <span class=\"etiket\">What the evidence shows for older recipients<\/span>\n    <p>Infections are somewhat more common. But <b>rejection attacks are less frequent and less\n      severe<\/b> than in younger patients \u2014 an older immune system fights the new kidney less.<\/p>\n    <p>The transplanted kidney lasts about <b>as long as it does in younger recipients<\/b>. And\n      five-year survival is <b>higher than for people of the same age who stay on dialysis<\/b>.<\/p>\n  <\/div>\n\n  <p>Many teams now match kidneys from older donors to older recipients \u2014 a practical way to\n     give more patients in this age group a transplant.<\/p>\n\n  <div class=\"soru\">\n    <h3>So what actually decides it?<\/h3>\n\n    <p>Your heart, lungs and blood vessels \u2014 not your age. Every candidate over 50 is screened\n       for heart disease and for cancer before transplantation. If those tests are acceptable,\n       being 72 is not in itself a reason to say no.<\/p>\n  <\/div>\n\n  <h2>\"You weigh too much\" \u2014 and \"you weigh too little\"<\/h2>\n\n  <p>Weight is the one area where there is a <b>firm threshold<\/b>. International guidelines\n     state that kidney transplantation is not appropriate at a BMI of <b>40 kg\/m\u00b2 or more<\/b>.<\/p>\n\n  <p>The reason is not cosmetic. Obese recipients carry a higher risk of <b>heart and blood\n     vessel disease<\/b> and of <b>surgical complications<\/b>, and both the patient and the kidney\n     do less well over the long term \u2014 mainly for cardiovascular reasons, and secondly because\n     of infection.<\/p>\n\n  <div class=\"tblwrap\">\n    <table>\n      <thead>\n        <tr><th>BMI<\/th><th>What it means for transplantation<\/th><\/tr>\n      <\/thead>\n      <tbody>\n        <tr><td><b>Below 20<\/b><\/td><td>Higher risk of infection and delayed wound healing; shorter life expectancy on dialysis and after transplant<\/td><\/tr>\n        <tr><td><b>20 \u2013 30<\/b><\/td><td>The target range<\/td><\/tr>\n        <tr><td><b>30 \u2013 40<\/b><\/td><td>Transplantation possible; weight-loss support recommended<\/td><\/tr>\n        <tr><td><b>40 or above<\/b><\/td><td><b>Not appropriate<\/b> \u2014 weight must come down first<\/td><\/tr>\n      <\/tbody>\n    <\/table>\n  <\/div>\n\n  <p>A BMI above 40 is a \"not yet\", not a \"never\". Patients on the waiting list are given\n     diet programmes and encouraged towards a BMI below 30. After transplantation in heavier\n     patients, the team may also <b>reduce or stop cortisone-type medicines sooner<\/b>, because\n     these drive weight gain.<\/p>\n\n  <p>The same applies in the other direction. <b>Extreme thinness<\/b> is a real risk that is\n     talked about far less. A patient who is underweight should be helped to gain weight\n     before surgery.<\/p>\n\n  <h2>\"Your first transplant failed \u2014 there is nothing more we can do\"<\/h2>\n\n  <p>This is heard more and more often, simply because more people received a first kidney\n     ten or twenty years ago. In the United States, <b>loss of a transplanted kidney is the fifth\n     most common reason for starting dialysis<\/b>.<\/p>\n\n  <p>A second transplant is not only possible \u2014 for these patients it is the <b>best treatment\n     available<\/b>. Patients whose transplant has failed do worse on dialysis than other\n     dialysis patients, and the ideal is to receive the second kidney <b>before returning to\n     dialysis at all<\/b>.<\/p>\n\n  <h3>What predicts success the second time<\/h3>\n\n  <div class=\"tblwrap\">\n    <table>\n      <thead>\n        <tr><th>How the first kidney was lost<\/th><th>Outlook for the second<\/th><\/tr>\n      <\/thead>\n      <tbody>\n        <tr><td>First kidney worked for <b>more than 4 years<\/b><\/td><td><b>84%<\/b> of second kidneys still working at 3 years<\/td><\/tr>\n        <tr><td>First kidney lost within <b>46 days<\/b><\/td><td>Despre <b>40%<\/b> of second kidneys still working at 5 years<\/td><\/tr>\n      <\/tbody>\n    <\/table>\n  <\/div>\n\n  <p>Two further factors matter:<\/p>\n\n  <ul>\n    <li><b>Why the first kidney failed.<\/b> If it was lost to an early rejection attack, or\n        because the original kidney disease came back, the team plans the second transplant\n        differently \u2014 including the choice between a living and a deceased donor. In other\n        cases, a <b>living donor is preferred<\/b>.<\/li>\n    <li><b>Time on dialysis between the two.<\/b> The longer the gap, the higher the risk.\n        Patients with <b>five years or more<\/b> on dialysis between transplants carry the\n        greatest risk \u2014 another reason not to wait.<\/li>\n  <\/ul>\n\n  <div class=\"soru\">\n    <h3>My original disease came back in the first kidney. Is a second one pointless?<\/h3>\n\n    <p>No. Guidelines state that a repeat transplant <b>should be considered<\/b> even when the\n       first kidney was lost to recurrence of the original disease. In rare cases the risk of\n       recurrence can be high, but how fast it progresses cannot be predicted \u2014 and it is not\n       a reason to refuse outright.<\/p>\n  <\/div>\n\n  <div class=\"box efsane\">\n    <span class=\"etiket\">The myth<\/span>\n    <p><b>\"There is an age limit for kidney transplantation.\"<\/b><\/p>\n    <p>At most centres there is not. Advanced age is formally listed as <b>not a\n      contraindication<\/b>. If you have been refused on age alone, ask what the actual medical\n      reason is \u2014 and get a second opinion.<\/p>\n  <\/div>\n\n  <div class=\"yazar\">\n    <div class=\"rozet\">MT<\/div>\n    <div>\n      <h3><a href=\"https:\/\/bookinghospital.org\/ro\/murat-tuncer-md\/\" style=\"color:inherit\">Profesorul Dr. Murat Tuncer<\/a><\/h3>\n      <p>Nephrologist and transplant physician. Author of <i>Kidney Transplantation \u2014 With\n        Questions and Answers<\/i> (Istanbul, 2020).<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"cta\">\n    <h2>Turned down somewhere else? Send us your reports<\/h2>\n    <p>Tell us your age, your BMI and \u2014 if you have had a transplant before \u2014 how long it\n       worked. We will tell you honestly whether a transplant is realistic, including when the\n       answer is no.<\/p>\n    <div class=\"btns\">\n      <a class=\"btn btn-1\" href=\"https:\/\/bookinghospital.org\/ro\/medical-tourism\/\">Send your medical reports<\/a>\n      <a class=\"btn btn-2\" href=\"\/ro\/category\/kidney-transplant-guide\/\">More patient guides<\/a>\n    <\/div>\n  <\/div>\n\n  <div class=\"uyari\">\n    <p><b>Medical disclaimer.<\/b> This article is general information adapted from a published\n      book. It is not personal medical advice, it does not establish a doctor\u2013patient\n      relationship, and it cannot replace assessment by the physician treating you. Eligibility\n      for transplantation is decided by a transplant team after detailed testing. Always\n      consult a transplant centre before making decisions about your treatment.<\/p>\n  <\/div>\n\n  <div class=\"kaynak\">\n    <h3>References<\/h3>\n    <ol>\n      <li>Abramowicz D, Cochat P, Claas FH, et al. European Renal Best Practice Guideline on\n        kidney donor and recipient evaluation and perioperative care.\n        <i>Nephrol Dial Transplant<\/i> 2015;30(11):1790\u20131797.<\/li>\n      <li>Chadban SJ, Ahn C, Axelrod DA, et al. KDIGO Clinical Practice Guideline on the\n        Evaluation and Management of Candidates for Kidney Transplantation.\n        <i>Transplantation<\/i> 2020;104(4S1):S11\u2013S103.<\/li>\n    <\/ol>\n  <\/div>\n\n<\/section>\n\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Kidney transplantation \u00b7 Who can receive Told you are too old, too heavy, or that your first transplant was your only chance? These are three of the most common reasons patients are turned away. Only one of them is ever a firm line \u2014 and even that one can usually be moved. Written by Prof. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"elementor_header_footer","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"_joinchat":[],"footnotes":""},"categories":[16],"tags":[],"class_list":["post-2961","post","type-post","status-publish","format-standard","hentry","category-kidney-transplant-guide"],"_links":{"self":[{"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/posts\/2961","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/comments?post=2961"}],"version-history":[{"count":4,"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/posts\/2961\/revisions"}],"predecessor-version":[{"id":2968,"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/posts\/2961\/revisions\/2968"}],"wp:attachment":[{"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/media?parent=2961"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/categories?post=2961"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bookinghospital.org\/ro\/wp-json\/wp\/v2\/tags?post=2961"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}