Related Experiment Video
Updated: May 30, 2026
Isolation and Transplantation of Different Aged Murine Thymic Grafts.
Published on: May 13, 2015
Is age a limiting factor for access to transplantation?
L Almenar-Bonet1, I J Sánchez-Lázaro, L Martínez-Dolz
1Heart Failure and Transplantation Unit, Cardiology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain. lualmenar@gmail.com
Insights
Heart transplantation (HTx) is increasingly viable for patients over 65. Despite higher infection rates, older recipients show similar long-term survival and fewer rejections compared to younger patients.
Area of Science:
- Cardiology
- Transplantation Medicine
- Geriatric Medicine
Background:
- Increasing life expectancy leads to more elderly patients needing heart transplantation (HTx).
- Traditionally, age over 65 was a contraindication for HTx due to comorbidities and reduced long-term benefits.
- Donor organ shortage prioritized younger recipients.
Purpose of the Study:
- To evaluate the feasibility and outcomes of heart transplantation in patients aged 65 years and older.
- To compare the results of HTx in older recipients versus younger recipients.
Main Methods:
- Review of recent studies on heart transplantation in elderly populations.
- Analysis of recipient selection criteria and immunosuppressive strategies.
- Comparison of outcomes including infections, hospital stay, rejection rates, and survival.
Main Results:
- Heart transplantation in patients over 65 is possible and yields comparable medium and long-term survival rates to younger patients.
- Older recipients experienced more infections and longer hospital stays but demonstrated fewer rejections.
- Improved outcomes are attributed to careful recipient selection and individualized immunosuppression.
Conclusions:
- Heart transplantation is a viable option for carefully selected elderly patients.
- Further multicenter studies are needed to define the role of waiting lists and ventricular assist devices in this demographic.
Abstract:
As a result of increased life expectancy and quality of life, there is an increasing number of patients older than 65 years of age who require the possibility of heart transplantation (HTx). Traditionally, recipient age older than 65 years has been considered a contraindication for performing a HTx because these patients have more comorbidities, are more affected by the adverse effects of immunosuppressive drugs, and obtain a smaller benefit in the medium and long term. Therefore, given the shortage of donors, priority was given to younger recipients. In recent years, studies have been published demonstrating that HTx in this population segment is possible. These results indicate that despite suffering more infections and having longer hospital stays, these patients have fewer rejections, with an overall survival in the medium and long term similar to that of HTx in younger patients. These results have been achieved partly as a result of appropriate selection of recipients and emergence of new immunosuppressive agents that has allowed their use to be individualized to the characteristics and comorbidities of each patient. Despite the latest advances, longer-term multicenter studies are required to clarify the role of alternate lists and the impact of new ventricular assist devices in this population segment.
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