Despite proven benefits, seniors have not pursued kidney transplants to the same extent as their younger cohorts. Objective: To examine the beliefs and perceived barriers toward kidney transplantation of seniors with chronic kidney disease (CKD) and end-stage kidney disease (ESRD). Methods: In-depth qualitative interviews were conducted with adults age 65 and older, with CKD and ESRD, who received care in a geriatrics outpatient medicine clinic. Using content analysis and constant comparative analysis, three coders analyzed the interview data for common themes. Results: A total of 35 seniors completed qualitative interviews (mean age 73.1 years, 68.9% female, 62.1% widowed/ divorced). Seniors generally supported the idea of kidney transplantation, although they reported perceptions that they were too old to receive an organ or their organs are too old to be used for transplantation. Many of the seniors knew someone younger than 65 years who had had a solid organ transplant but felt that being over age 65 was too old for kidney transplantation. From a donation perspective, seniors were willing to donate an organ if asked but had not signed their driver licenses as an organ donor due to perceptions that their organs were too old. Some seniors did not feel comfortable asking relatives or friends for donation, especially younger relatives. Of those who felt comfortable asking, most seniors felt that they would ask their children. Lack of social network was not a perceived barrier. Many seniors would not accept a kidney from a deceased donor as they felt those kidneys should be utilized for younger patients. Health was not a perceived barrier to being a transplant recipient as most seniors felt they were healthy and could undergo a surgery. Conclusion: Many seniors perceive age as the main barrier to kidney transplantation (both donating and receiving). Health, lack of social networks, religion, and ability to navigate the healthcare system were not perceived as barriers. It is intriguing that seniors reflect ageist views on whether they are candidates for kidney transplantation. Informing patients and correcting these age misperceptions are necessary for improving kidney transplantation utilization among seniors.

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