Related Experiment Video
Updated: Jul 13, 2026
A High-Fidelity Porcine Model of Orthotopic Heart Transplantation Following Donation after Circulatory Death
Published on: June 6, 2025
Heart transplantation in older candidates
A Forni1, G Faggian, B Chiominto
1Division of Cardiac Surgery University Hospital of Verona, Verona, Italy. albertoforni1959@alice.it
Insights
Older heart transplant (HTX) recipients aged 61-70 years can benefit from HTX using marginal donors. This study found no significant differences in outcomes for these patients compared to younger recipients.
Area of Science:
- Cardiology
- Transplantation Medicine
- Geriatric Medicine
Background:
- Heart transplantation (HTX) recipient profiles are evolving.
- New chronic heart failure therapies have created a cohort of older candidates (61-70 years).
- These older patients may require organs from marginal donors.
Purpose of the Study:
- To evaluate the outcomes of heart transplantation in older recipients (61-70 years) using marginal donors.
- To identify potential negative prognostic factors in this patient group.
Main Methods:
- Retrospective review of 272 heart transplant recipients from May 1994 to December 2005.
- Group 1: 75 patients aged 61-72 years; Group 2: 197 patients aged 18-60 years.
- Comparison of demographics, pre-HTX status, donor characteristics, and outcomes between groups.
Main Results:
- Group 1 patients more frequently received organs from marginal donors (89% vs 29%).
- No significant differences were observed in actuarial survival, perioperative mortality, or rejection rates between groups.
- Freedom from infection, neoplasia, and chronic renal failure also showed no significant differences.
Conclusions:
- Heart transplantation is a viable option for selected older patients (61-70 years) with chronic heart failure.
- Marginal donors can be utilized successfully in older recipients without compromising outcomes.
- Advances in medical therapy have expanded the eligibility criteria for heart transplantation.
Unlabelled:
Over the last few years significant changes have occurred in both donor and recipient profiles for heart transplantation (HTX). New therapeutic approaches to chronic heart failure have created a novel class of patients aged between 61 and 70 years. Although they are older than the conventional upper limit, they may undergo HTX using marginal donors. We retrospectively reviewed the outcomes of suboptimal donor implants in older recipients to examine negative prognostic factor.
Methods:
Among 272 patients who underwent HTX at our institution from May 1994 to December 2005, 75 (26.5%) were 61 to 72 years (group 1). The remaining 197 (73.5%) denoted as group 2 ranged in age from 18 to 60 years. The Sex distribution, cause of end-stage heart failure, preoperative pulmonary hypertension, pre-HTX clinical status and mean follow-up did not show any significant difference between the two groups. However, group 1 patients had their organs retrieved from marginal donors (89%) vs group 2 (29%; P < .005). They were deceased mainly due to cerebrovascular events, (namely, 82% vs 27%, respectively, P < .005).
Results:
All analyzed variables-actuarial survival, perioperative mortality, 12-month acute rejection freedom, 100-month chronic rejection freedom, infection freedom, neoplasia freedom, chronic renal failure freedom-did not show any significant difference.
Conclusion:
Advances in chronic heart failure medical therapy have generated a new class of HTX candidates aged between 61 and 70 years who benefitted from transplantation of organs retrieved from suboptimal donors.
