A critical analysis of morbidity and mortality as it relates to recipient age following cardiac transplantation.
Older patients (age greater than 55) are now being accepted as candidates for cardiac transplantation.  The outcome following cardiac transplantation in this older age group has been largely limited to an analysis of mortality and rejection and infection incidence. In addition to these factors, this report investigates whether morbidity related to other organ system disease is greater in older patients.  Seventy-eight cardiac transplant operations in patients aged 15 through 64 have been performed using the identical immunosuppression protocol from December 1985 to May 1989.  Of these, 58 patients were under the age of 55 (younger), and 20 were 55 years of age or older (older).  One- and 2-yr survival tended to be lower in the older group compared to the younger group, but was not statistically significant (1 yr--87% vs. 77%, respectively; 2 yr--84% vs. 77%, respectively, p=0.143).  There were no statistical differences between groups in length of initial transplant hospitalization, number of readmissions or total duration of time in hospital (including readmissions) either absolutely or normalized to total months of follow-up for each patient.  Neurologic and vascular problems represented a greater proportion of readmissions and rejection a lower proportion of readmissions in the older group compared to the younger group (p less than 0.05).  Using hospitalization as a marker for important morbidity, there appears to be little impact of older age on post-cardiac transplant outcome.
Hosenpud
J D
JD
The Cardiac Transplant Program of the Oregon Health Sciences University, Portland.
Pantely
G A
GA
Norman
D J
DJ
Cobanoglu
A M
AM
Hovaguimian
H
H
Starr
A
A
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D006084:Graft Rejection; D016027:Heart Transplantation / Q000401:mortality*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010359:Patient Readmission; D011183:Postoperative Complications / Q000401:mortality; D015996:Survival Rate