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[Heart transplant over 55 years]

C Pederzolli1, L Martinelli, A M Grande

  • 1Divisione di Cardiochirugia Centro C. Dubost, IRCCS Policlinico S. Matteo, Pavia.

Giornale Italiano Di Cardiologia
|March 1, 1997
PubMed
Summary

Heart transplantation is a viable option for patients over 55. Careful pre-operative screening is essential, and older donors can be considered, showing excellent long-term survival rates.

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Area of Science:

  • Cardiology
  • Transplant Surgery
  • Geriatric Medicine

Background:

  • Recipient age historically influenced heart transplant outcomes, often excluding older patients.
  • Advancements in immunosuppression, like cyclosporine, prompted re-evaluation of age-based selection criteria.
  • This study retrospectively analyzed heart transplant outcomes in recipients aged 55 years or younger versus older than 55.

Purpose of the Study:

  • To evaluate the impact of recipient age on heart transplantation outcomes.
  • To compare the efficacy and safety of heart transplantation in patients above and below 55 years.
  • To determine if age > 55 is a contraindication for heart transplantation.

Main Methods:

  • Retrospective analysis of 437 heart transplant recipients.

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  • Patients divided into two groups: Group A (<= 55 years) and Group B (> 55 years).
  • Immunosuppression: cyclosporine, azathioprine, and prednisone; analysis of pre- and post-operative demographic, clinical, and hemodynamic data.

    • Main Results:

    • Group A had more dilated cardiomyopathy; Group B had more ischemic cardiomyopathy (p < 0.001).
    • Post-operative complications, intensive care, and mortality were higher in Group B, though not significantly.
    • Long-term survival rates were similar between groups (5-year: 80.3% vs 75.4%; 7-year: 72.9% vs 71%).
    • Group B showed higher incidence of tumors (p < 0.05) and peripheral vascular complications (p < 0.01).

    Conclusions:

    • Heart transplantation is a valid therapeutic option for patients over 55 with end-stage heart disease.
    • Excellent long-term survival is achievable in older recipients.
    • Rigorous pre-operative assessment and consideration of older donors are recommended.