HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Philippe Demers Philip E. Oyer Bruce A. Reitz Robert C. Robbins Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Demers, P. Articles by Robbins, R. C. Search for Related Content PubMed PubMed Citation Articles by Demers, P. Articles by Robbins, R. C. Related Collections Transplantation - heart

J Thorac Cardiovasc Surg 2003;126:224-231
© 2003 The American Association for Thoracic Surgery

Cardiothoracic transplantation

Long-term results of heart transplantation in patients older than 60 years

^a Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.USA

Received for publication September 14, 2002; accepted for publication November 1, 2002.

^* Address for reprints: Robert C. Robbins, MD, Department of Cardiothoracic Surgery, Falk Cardiovascular Research Center, Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5247, USA
robbins{at}stanford.edu

BACKGROUND: Advanced age has been traditionally considered a relative contraindication for heart transplantation. Older patients are now considered as potential candidates for heart transplantation. The objective of this study was to evaluate the long-term results of heart transplantation in patients older than 60 years.

METHODS: Between 1986 and 2001, 81 patients aged between 60 and 70 years (mean, 63 ± 2 years) underwent heart transplantation. These patients were compared with 403 adult recipients younger than 60 years (mean, 47 ± 11 years) who underwent transplantation during the same period.

RESULTS: Thirty-day mortality was 6% (5/81) and 6% (25/403) in the older and younger patients, respectively (P = NS). Actuarial survival at 1, 5, and 10 years was 88% ± 4% versus 83% ± 2%, 75% ± 5% versus 69% ± 2%, and 50% ± 9% versus 51% ± 3% in the older and younger patients, respectively (P = NS). Older patients had significantly fewer rejection episodes (P = .003). Freedom from allograft coronary artery disease at 1, 5, and 10 years was 98% ± 2% versus 92% ± 2%, 85% ± 6% versus 76% ± 3%, and 81% ± 7% versus 68% ± 3% (P = .1). The incidences of infectious complication, cytomegalovirus infection, and posttransplant lymphoproliferative disorder were similar between the 2 groups, but older recipients were more likely to have a nonposttransplant lymphoproliferative disorder cancer (P = .002). Age at transplantation was not identified as an independent risk factor for early and late death.

CONCLUSION: Heart transplantation in selected patients aged 60 years and older results in survival comparable with that of younger patients. Older patients have a lower risk of rejection but an increased risk of development of a nonposttransplant lymphoproliferative disorder cancer. Advanced age per se should not be considered as an exclusion criterion for transplantation.

This article has been cited by other articles:

				Y. S. Tjang, G. J.M.G. van der Heijden, G. Tenderich, R. Korfer, and D. E. Grobbee Impact of Recipient's Age on Heart Transplantation Outcome Ann. Thorac. Surg., June 1, 2008; 85(6): 2051 - 2055. [Abstract] [Full Text] [PDF]

				R. Mahidhara, S. Bastani, D. J. Ross, R. Saggar, J. Lynch III, G. T. Schnickel, D. Gjertson, R. Beygui, and A. Ardehali Lung transplantation in older patients? J. Thorac. Cardiovasc. Surg., February 1, 2008; 135(2): 412 - 420. [Abstract] [Full Text] [PDF]

				L. U. Nwakanma, A. S. Shah, J. V. Conte, and W. A. Baumgartner Heart Transplantation Card. Surg. Adult, January 1, 2008; 3(2008): 1539 - 1578. [Full Text]