REVIEW article
Front. Transplant.
Sec. Transplantation Immunology
Volume 4 - 2025 | doi: 10.3389/frtra.2025.1566466
The Perioperative Management of Geriatric Patients in Transplantation Surgery -Clinical, Immunological, and Translational Considerations
Provisionally accepted
Leonard Knoedler1*
Sam Boroumand2Christopher A Hinze3
Samuel Knoedler2
Bhagvat Maheta4
Jasper Iske5,6
Adriana C Panayi1- 1Institute of Occupational Medicine, Charité – University Medicine Berlin, corporate member of Freie University, Berlin and Humboldt-University of Berlin, Berlin, Germany
- 2Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Yale University, New Haven, United States
- 3Hannover Medical School, Hanover, Germany
- 4California Northstate University, Elk Grove, United States
- 5Kompetenzzentrum für Thoraxchirurgie, Charité – Universitätsmedizin Berlin, Berlin, Germany
- 6Department of Cardiothoracic and Vascular Surgery, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
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Transplant surgery encompasses two primary branches: solid organ transplantation (SOT) and vascularized composite allotransplantation (VCA). As the global population ages, elderly transplant patients become a more pressing clinical challenge. Elderly transplant recipients require specialized care that addresses their unique needs, including increased comorbidities and frailty.Despite the growing recognition of these challenges, there is a paucity of studies that synthesize the current knowledge on this patient cohort, from immunological changes over translational challenges to tailored clinical care. This review highlights the individual needs of elderly transplant patients, emphasizing the importance of understanding their clinical profiles to develop specialized perioperative management strategies. The clinical need for tailored therapeutic concepts contrasts with the current lack of established, integrated care models specifically designed for older adults undergoing SOT and VCA. Overall, future research is warranted to provide individualized and cross-disciplinary care models for aging transplant patients and broaden the access to transplant surgery for this patient population.
Keywords: Geriatrics, Frailty, solid organ transplant, SOT, Vascularized Composite Allotransplantation, VCA
Received: 24 Jan 2025; Accepted: 11 Aug 2025.
Copyright: © 2025 Knoedler, Boroumand, Hinze, Knoedler, Maheta, Iske and Panayi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Leonard Knoedler, Institute of Occupational Medicine, Charité – University Medicine Berlin, corporate member of Freie University, Berlin and Humboldt-University of Berlin, Berlin, Germany
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