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Cervical Heterotopic Mouse Heart Transplantation using End-to-side Anastomosis Technique to Study Transplant Immunology
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Long-term results of heart transplantation in patients older than 60 years

Philippe Demers1, Susan Moffatt, Philip E Oyer

  • 1Department of Cardiothoracic Surgery, Stanford University School of Medicine, CA 94305-5247, USA.

The Journal of Thoracic and Cardiovascular Surgery
|July 25, 2003
PubMed

Insights

Heart transplantation is safe for patients over 60, showing comparable survival rates to younger recipients. Older individuals experienced fewer rejections but a higher risk of non-posttransplant lymphoproliferative disorder cancer.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Geriatric Medicine

Background:

  • Traditionally, advanced age was a contraindication for heart transplantation.
  • Increasingly, older individuals are considered for heart transplantation.
  • This study evaluates long-term outcomes in heart transplant recipients over 60.

Purpose of the Study:

  • To assess the long-term efficacy and safety of heart transplantation in patients aged 60 years and older.
  • To compare outcomes between older (≥60 years) and younger (<60 years) heart transplant recipients.

Main Methods:

  • A retrospective analysis of 81 heart transplant recipients aged 60-70 years compared with 403 younger recipients (1986-2001).
  • Outcomes analyzed included 30-day mortality, actuarial survival, rejection episodes, allograft coronary artery disease, and post-transplant complications.

Main Results:

  • Thirty-day mortality was similar (6%) in both older and younger groups.
  • Actuarial survival at 1, 5, and 10 years was comparable between groups (e.g., 10-year survival: 50% +/- 9% vs. 51% +/- 3%).
  • Older patients had significantly fewer rejection episodes but a higher incidence of non-posttransplant lymphoproliferative disorder cancer; other complications were similar.

Conclusions:

  • Heart transplantation in selected patients aged 60 and older yields survival rates comparable to younger recipients.
  • Advanced age is not an independent risk factor for mortality after heart transplantation.
  • While older recipients have a lower risk of rejection, they face an increased risk of non-posttransplant lymphoproliferative disorder cancer.
Abstract

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