Is age a limiting factor for access to transplantation?

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.