Thoracic transplantationCardiac: OutcomeHeart Transplantation in Patients Aged 70 Years and Older: A Two-Decade Experience
Section snippets
Patients and Methods
Consecutive recipients of single-organ OHT performed at Cedars-Sinai Medical Center from December 1988 to December 2009 were reviewed. Recipients were divided into three groups based on age at transplant: ≥ 70-years old (group 1), 60- to 69-years old (group 2), and < 60-years old (group 3). Primary endpoints were 30 days and 1-, 5-, and 10-years survival, respectively. Secondary outcomes included re-operation for bleeding, postoperative need for dialysis, and postoperative intubation and
Results
We reviewed 519 consecutive first-time single-organ OHTs at Cedars-Sinai Medical Center from December 1988 through December 2009. The mean age was 48.5 ± 10.0 years (range, 14.8 years to 59.9 years) in the youngest group, 64.9 ± 2.8 years (range, 60.0 years to 69.8 years) in patients 60- to 69-years old, and 73.3 ± 2.1 years (range, 70.0 years to 77.7 years) in the oldest age group. Preoperative patient characteristics and donor characteristics by age groups are listed in Table 1 and Table 2,
Discussion
This study describes the largest cohort of OHT recipients to date who were ≥70 years old of age at the time of transplant, and reveals similar morbidity and mortality when compared with younger recipients. Thirty-day (operative) survival, along with 10-year survival after heart transplantation in the oldest age group was similar to recipients between 60 and 69 years of age and those ≤60-years old. The main criticism of OHT in elderly patients has been that they may not have the same duration of
Conclusion
The findings in this study comparing septuagenarians to younger OHT recipients reveal that advanced age should not be a contraindication for heart transplantation. As life expectancy continues to increase, it will be necessary to continually redefine what is considered elderly. At the current time, there are no guidelines on the upper age limit for OHT, but this study shows promising results for those patients who are ≥70 years of age. Although there is a growing gap between cardiac organ
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