Heart transplantation in patients over age fifty-five years

The age limit for heart transplantation remains undefined. The shortage of available donors coupled with fears of increased morbidity and mortality in older patients has until recently resulted in a limited application of heart transplantation in patients over age 50 years. In 1986, however, data from the International Heart Transplant Registry demonstrated that 25% of all patients undergoing this procedure were over age 55 years. This study reviews our experience with 30 consecutive patients who underwent heart transplantation over a 15-month period. There were eight patients over age 55 years (group 1) and 22 patients under age 55 years (group 2). We compared the hospital course and incidence of infection and rejection and other complications after heart transplantation between the two groups. Carefully selected patients between ages 55 and 60 years can undergo transplantation with similar expectations to younger patients for survival, complications, and rehabilitation, including employability. Caution is warranted in extrapolating these optimistic data to patients older than age 50 years.