title: Are heart valves from donors over 65 years of age morphologically suitable for transplantation?
abstract: Since there is no upper age limit for general organ donation, unlike heart valve donation, and since a quarter of all organ donors are 65 years and older, we examined whether the heart valves from these donors are suitable as allografts. In the period 1999-2004 the aortic valve and pulmonary valve of 100 organ donors above 65 years of age were examined to establish whether they would have been suitable as valve grafts. To compare the valve grafts above and below the age limit of 65 years, we used data on the aortic and pulmonary valves of 380 organ donors below the age limit in the same time period. Examination of the 200 heart valves showed that - just like valves from donors below the age limit - 100 of them would have met the medical quality standards for transplantation, which discriminate among optimal, suitable and unsuitable tissue morphology. The morphological suitability of the aortic valves decreases rapidly during the 4th decade of life and near to the age limit only 6% of them are accepted as grafts. The rate of potentially acceptable aortic valve grafts from organ donors aged over 65 years of 15% is also small. By contrast, the pulmonary valves are not affected by age-related tissue changes that might reduce their transplantability. The predominant majority (85%) of potential pulmonary valve grafts from organ donors over 65 years of age fulfilled the acceptance criteria, half of them (48%) even showing good tissue quality. In light of these results the age limit was raised to 70 years in 2005.
authors.affiliation: North-East Donor Region, German Organ Transplantation Foundation (DSO), Saatwinkler Damm 11-12, 13627 Berlin, Germany. katharina.grosse@dso.de
authors.forename: Katharina
authors.initials: K
authors.lastname: Grosse
authors.forename: Rudolf
authors.initials: R
authors.lastname: Meyer
authors.forename: Erna
authors.initials: E
authors.lastname: Schmitzer
authors.forename: Roland
authors.initials: R
authors.lastname: Hetzer
authors.forename: Claus
authors.initials: C
authors.lastname: Wesslau
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology*; D001021:Aortic Valve / Q000473:pathology / Q000637:transplantation; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006351:Heart Valves / Q000473:pathology* / Q000637:transplantation*; D006801:Humans; D008297:Male; D011664:Pulmonary Valve / Q000473:pathology / Q000637:transplantation; D009927:Tissue and Organ Procurement; D014184:Transplantation, Homologous