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Updated: Jul 11, 2026
A Simplified Model for Heterotopic Heart Valve Transplantation in Rodents
Published on: September 21, 2021
Are heart valves from donors over 65 years of age morphologically suitable for transplantation?
Katharina Grosse1, Rudolf Meyer, Erna Schmitzer
1North-East Donor Region, German Organ Transplantation Foundation (DSO), Saatwinkler Damm 11-12, 13627 Berlin, Germany. katharina.grosse@dso.de
Insights
Older organ donors aged over 65 can provide suitable heart valves for transplantation. Pulmonary valves from these donors are highly suitable, supporting an increased age limit for valve donation.
Area of Science:
- Cardiology
- Transplantation Medicine
- Gerontology
Background:
- Organ donation age limits vary, with no upper limit for general organs but restrictions for heart valves.
- A significant portion of organ donors (25%) are aged 65 and older.
- The suitability of heart valves from older donors for transplantation remains a critical question.
Purpose of the Study:
- To evaluate the suitability of aortic and pulmonary valves from organ donors over 65 years old as allografts.
- To compare the quality of heart valves from donors above and below the age of 65.
- To inform potential adjustments to age-related policies for heart valve donation.
Main Methods:
- Examined aortic and pulmonary valves from 100 organ donors aged 65+ (1999-2004).
- Compared findings with data from 380 organ donors below 65 in the same period.
- Assessed valve suitability based on medical quality standards for transplantation, including tissue morphology.
Main Results:
- 100 out of 200 examined heart valves (50%) met medical quality standards.
- Aortic valve suitability decreased significantly with age; only 15% from donors over 65 were potentially acceptable.
- Pulmonary valves showed high suitability (85%) in donors over 65, with 48% of excellent quality, unaffected by age-related changes.
Conclusions:
- Pulmonary valves from older donors (65+) are highly suitable for transplantation.
- Aortic valves from older donors are less suitable due to age-related morphological changes.
- The study's findings supported raising the age limit for heart valve donation to 70 in 2005.
Abstract:
Since there is no upper age limit for general organ donation, unlike heart valve donation, and since a quarter of all organ donors are 65 years and older, we examined whether the heart valves from these donors are suitable as allografts. In the period 1999-2004 the aortic valve and pulmonary valve of 100 organ donors above 65 years of age were examined to establish whether they would have been suitable as valve grafts. To compare the valve grafts above and below the age limit of 65 years, we used data on the aortic and pulmonary valves of 380 organ donors below the age limit in the same time period. Examination of the 200 heart valves showed that - just like valves from donors below the age limit - 100 of them would have met the medical quality standards for transplantation, which discriminate among optimal, suitable and unsuitable tissue morphology. The morphological suitability of the aortic valves decreases rapidly during the 4th decade of life and near to the age limit only 6% of them are accepted as grafts. The rate of potentially acceptable aortic valve grafts from organ donors aged over 65 years of 15% is also small. By contrast, the pulmonary valves are not affected by age-related tissue changes that might reduce their transplantability. The predominant majority (85%) of potential pulmonary valve grafts from organ donors over 65 years of age fulfilled the acceptance criteria, half of them (48%) even showing good tissue quality. In light of these results the age limit was raised to 70 years in 2005.
