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Heart transplantation for patients over age 60
J E Everett1, A R Djalilian, S H Kubo
1Department of Surgery, University of Minnesota, Minneapolis, USA.
Clinical Transplantation
|December 1, 1996
Summary
Heart transplantation is safe and effective for patients over age 60. Survival rates for older heart transplant recipients are comparable to younger patients, with fewer rejection episodes but increased risks of malignancy and osteoporosis.
Area of Science:
- Cardiology
- Transplantation Medicine
- Geriatric Medicine
Background:
- Increasing proportion of individuals over 60 years old.
- Advanced recipient age is an exclusion criterion for heart transplantation, with an undefined upper limit.
- Growing need for heart transplant candidates in an aging population.
Purpose of the Study:
- To analyze the outcomes of heart transplant recipients over age 60.
- Evaluate early and late morbidity and mortality in this cohort.
- Compare outcomes with younger heart transplant recipients.
Main Methods:
- Retrospective analysis of 31 heart transplant recipients over age 60.
- Follow-up for early and late morbidity and mortality.
- Comparison with younger recipients (age 18-59) transplanted during the same period.
Main Results:
- Mean follow-up of 50 months.
- 1-year survival rate of 90% and 5-year survival rate of 85%.
- Survival rates were not significantly different compared to younger recipients.
- Older recipients had more osteoporotic changes and malignancies but infrequent rejection episodes.
Conclusions:
- Heart transplantation is safe and effective for patients over 60 with end-stage congestive heart failure.
- Survival rates are comparable to younger recipients.
- Individualized immunosuppression may reduce malignancy incidence; donor-recipient age matching is suggested.