The influence of donor age on transplant coronary artery disease and survival post heart transplantation: is it safe to extend donor age?
BACKGROUND
Due to the increasing demand for suitable cardiac donor organs, acceptance criteria need to be re-evaluated. We retrospectively analyzed the effect of donor age on survival following cardiac transplantation.


METHODS
Three hundred thirty-five cardiac transplant recipients and corresponding donor data were reviewed using SPSS.


RESULTS
Seventy-two recipients had early posttransplant angiography or postmortem data available. The mean donor age of recipients with evidence of graft coronary artery disease (32.5 +/- 11.7 years) was significantly higher than that of recipients free of transplant coronary artery disease (TCAD) (24.8 +/- 9.4 years; P=.003). Recipient of organs from donors aged less than 50 years were less likely to develop TCAD than those of donors aged over 50 years (odds ratio 0.333; 95% CI 0.239-0.465; P=.044). TCAD also occurred much earlier posttransplantation in recipients of organ from donors over 50 years (mean time 6.5 years; median 5.0 years) than those of donors under 50 years (mean time 12.7 years; median 14.0 years).


CONCLUSIONS
We observed no increase in mortality associated with cardiac donors over 50 years. However, increased donor age was associated with an increased incidence of TCAD.
Walker
A H
AH
Transplant Unit, Wythenshaw Hospital, Manchester, United Kingdom. tonywalker@hotmail.com
Fildes
J E
JE
Leonard
C T
CT
Yonan
N
N
D000328:Adult; D000367:Age Factors; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000401:mortality / Q000502:physiology*; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome