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Updated: Sep 16, 2025

Author Spotlight: Enhancing Graft Viability Assessment Through Quantitative Metrics and Innovative Reservoir Systems
08:49

Author Spotlight: Enhancing Graft Viability Assessment Through Quantitative Metrics and Innovative Reservoir Systems

Published on: August 2, 2024

993

Influences of age and obesity on heart transplant outcomes

Zach Rollins1, Ye In Christopher Kwon1, Graham Gardner1

  • 1Division of Cardiothoracic Surgery, Department of Surgery, Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, Va.

JTCVS Open
|July 9, 2025
PubMed

Insights

Heart transplant recipients with obesity (high-risk BMI) or older age (high-risk age) face worse survival. Patients with both risk factors had the poorest outcomes, yet 5-year survival remains significant.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Geriatric Medicine

Background:

  • Obesity and advanced age are recognized risk factors impacting long-term prognosis in heart transplant recipients.
  • Understanding outcomes in high-risk patient groups is crucial for optimizing post-transplant care.

Purpose of the Study:

  • To evaluate the 5-year survival rates of heart transplant patients with high-risk body mass index (BMI >30), high-risk age (>70 years), or both, compared to normal-risk recipients.
  • To analyze the impact of combined obesity and older age on heart transplant outcomes in the modern era.

Main Methods:

  • Analysis of adult heart transplant data in the US from 2014-2023.
  • Kaplan-Meier survival curves and log-rank tests to compare survival between normal-risk and high-risk groups (high-risk BMI, high-risk age, or both).
  • Risk-adjusted Cox regression to identify factors influencing overall survival.

Main Results:

  • A total of 15,839 normal-risk, 869 high-risk age, 8,187 high-risk BMI, and 202 high-risk both groups were analyzed.
  • Significant differences in overall survival were observed across groups (P < .001), with worse survival in high-risk categories.
  • Hazard ratios for mortality were 1.21 (high-risk BMI), 1.23 (high-risk age), and 1.72 (high-risk both). 5-year survival for high-risk both was 66.8%.

Conclusions:

  • Heart transplant recipients with high-risk BMI, high-risk age, or both demonstrate reduced overall survival compared to normal-risk patients.
  • Isolated high-risk BMI or high-risk age had similar survival impacts, while combined factors led to the worst outcomes.
  • Despite increased risks, 5-year survival rates, even in the combined high-risk group, underscore the continued benefit of heart transplantation.
Abstract

Keywords:
advanced agecardiac transplantcardiomyopathyclinical outcomesheart failureobesity

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