title: Heart transplantation in ischemic heart disease when recipients are older than 55 years and donors older than 50.
abstract: The purpose of this article is to analyze patients affected with ischemic cardiomyopathy, older than 55 years, who have undergone heart transplantation. We conducted a retrospective analysis comparing clinical course and outcome in patients whose donor age was > or = 50 years (Group A) with patients who had younger donor heart (Group B). Group A was composed of 25 patients, 55 to 68 years old (27.4% of the patients), 20 males and 5 females; Group B was composed of 68 patients, 55 to 66 years old, 65 males and 3 females. Mean donor age in Group A was 54.7 years old (range 51-61), while in Group B it was 29.5 years old (range 9-49). Operative mortality was 16% (4 cases) and 12% in Group B (8 cases) p = ns. Total mortality in Group A was 24%, or 6 cases: 2 graft failures, 1 infection, 1 neoplasm, 1 multiorgan failure, 1 ischemic heart disease; in Group B it was 27%, or 18 cases: 2 cerebrovascular accidents, 4 graft failures, 3 infections, 5 neoplasms, 3 multiorgan failures, 1 acute rejection, p = ns. Coronarography was performed in 51 patients, 14 in Group A (10 cases normal, 3 with irregularities, and 1 case with a critical stenosis of the circumflex artery; 37 in Group B (32 cases were normal, 3 had irregularities and 2 had critical stenosis in a coronary artery). In conclusion, we emphasize that extending donor age in recipients older than 55 years of age does not determine a higher risk and mortality.
authors.affiliation: Divisione di Cardiochirurgia, IRCCS Policlinico S. Matteo, Pavia.
authors.forename: A M
authors.initials: AM
authors.lastname: Grande
authors.forename: M
authors.initials: M
authors.lastname: Rinaldi
authors.forename: A M
authors.initials: AM
authors.lastname: D'Armini
authors.forename: C
authors.initials: C
authors.lastname: Pederzolli
authors.forename: C
authors.initials: C
authors.lastname: Campana
authors.forename: M
authors.initials: M
authors.lastname: Aiello
authors.forename: M
authors.initials: M
authors.lastname: Viganò
mesh_terms: D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000601:surgery*; D011379:Prognosis; D014019:Tissue Donors