Heart transplantation in the young and elderly
Related Experiment Video
Updated: Oct 7, 2026
A Porcine Heterotopic Heart Transplantation Protocol for Delivery of Therapeutics to a Cardiac Allograft
Published on: February 14, 2022
1Division of Cardiothoracic Surgery, University of California, Los Angeles 90095, USA.
Insights
Heart transplantation is effective for pediatric and elderly patients with end-stage heart disease. This study shows excellent long-term survival and low rates of transplant coronary artery disease in both age groups.
Area of Science:
- Cardiology
- Transplantation Medicine
- Pediatric Cardiology
Background:
- Heart transplantation is a viable treatment for pediatric end-stage and complex congenital heart disease.
- Expanded donor criteria have enabled successful transplantation in older recipients.
Purpose of the Study:
- To evaluate the efficacy and long-term outcomes of orthotopic heart transplantation in pediatric and elderly patient groups.
- To compare survival rates and freedom from transplant coronary artery disease (TCAD) between these two distinct age cohorts.
Main Methods:
- A retrospective analysis of 39 pediatric patients (16 days to 17.6 years) and 123 elderly patients (60 to 74.8 years) who underwent heart transplantation between July 1994 and June 1998.
- Analysis of primary indications for transplantation, including dilated cardiomyopathy (DCM) and congenital heart disease in pediatric patients, and ischemic cardiomyopathy and DCM in elderly patients.
Main Results:
- Thirty-day, 1-year, and 4-year survival rates were 97.4%, 87.2%, and 70.9% for pediatric recipients, and 92.7%, 81.3%, and 79.3% for elderly recipients, respectively.
- One and 4-year freedom from TCAD was 100.0% and 85.3% in the pediatric group, versus 91.9% and 83.3% in the elderly group.
Conclusions:
- Orthotopic heart transplantation is an effective treatment for irreparable congenital and end-stage heart disease.
- The procedure offers excellent long-term results for both pediatric and elderly patient populations.
Introduction:
Heart transplantation has become an acceptable treatment in pediatric patients with end-stage heart disease and complex congenital heart disease. The liberalization of recipient eligibility criteria, mainly age, along with the expansion of the donor pool has resulted in the acceptable transplantation of older recipients.
Methods:
Between July 1994 and June 1998, 39 pediatric patients aged 16 days to 17.6 years (median 6.68 years) and 123 elderly patients aged 60 to 74.8 years (median 64.1 years) were transplanted at our institution. In the pediatric group, 19 had idiopathic dilated cardiomyopathy (DCM) (46 %), 14 had congenital heart disease (34 %), 4 had other etiologies of cardiomyopathy (10 %), 2 had transplant coronary artery disease (TCAD) (5 %), and 1 each had acute rejection and graft failure. In the elderly group, 71 had ischemic cardiomyopathy (58 %), 38 had DCM (31 %), 9 had other forms of cardiomyopathy (7 %), and 5 had TCAD (4 %).
Results:
Thirty-day, 1-year, and 4-year survival was 97.4 %, 87.2 %, and 70.9 % for the pediatric group and 92.7 %, 81.3 %, and 79.3 % for the elderly group. One and 4-year freedom from TCAD was 100.0 % and 85.3 % for the pediatric group and 91.9 % and 83.3 % for the elderly group.
Conclusions:
[emsp3 ]Orthotopic heart transplantation is effective for the treatment of irreparable congenital and end-stage heart disease. It provides excellent long-term results in both the very young and elderly.
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