Interaction of Donor and Recipient Age: Do Older Heart Transplant Recipients Require Younger Hearts?

The Annals of Thoracic Surgery
Malini DanielPavan Atluri

Abstract

Older patients (aged 60 years or more) awaiting heart transplant often have comorbidities that may limit overall survival independent of cardiac status. We hypothesized that these comorbidities have a more-limiting impact on survival than age of donor heart and that older allografts might be utilized in these patients without compromising outcomes. We identified all transplant recipients aged more than 60 years in the United Network for Organ Sharing database. Local regression analysis detected the point above which increasing donor age incurred increasing risk of mortality, above and below which two cohorts were defined. Kaplan-Meier analysis compared cumulative 5-year survival between groups. Cox proportional hazard modeling was then used to determine the hazards of death in the two groups. An inflection point in posttransplant survival was detected near donor age 50 years. Of 14,113 older recipients studied, 86% received younger donor hearts (less than 50 years of age), and 14% received advanced age allografts (50 years of age or more). Baseline characteristics were comparable between groups except more recipients had left ventricular assist devices at time of transplant in the younger donor group (15% versus 9%, p < 0.001)....Continue Reading

Citations

Jul 23, 2019·Transplant International : Official Journal of the European Society for Organ Transplantation·Oliver K JawitzCarmelo Milano
Jul 13, 2020·Clinical Transplantation·Andrea LechiancoleUgolino Livi
Apr 1, 2019·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Torsten DoenstGloria Faerber
Dec 5, 2020·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Ricci KalayanamitraAshokkumar Jain
Jul 1, 2020·Revista Española De Cardiología·Raquel López-VilellaLuis Almenar-Bonet
Apr 9, 2021·Clinical Physiology and Functional Imaging·Annika IngvarssonCarl Meurling

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