title: Age and heart transplantation: results from a heart failure management unit.
abstract: BACKGROUND
  More evidence is needed to assess the pros and cons of maintaining age-limit policies in heart transplantation (HT).
  
  
  METHODS
  We analyzed clinical data from a heart failure management unit to investigate the impact of age on prognosis of two distinct cohorts: (i) 309 patients (median age, 57 yr; 62% male) with severe chronic heart failure (CHF) consecutively screened for HT; (ii) 336 HT recipients (median age 56 yr, 82% male).
  
  
  RESULTS
  In CHF patients (screened for HT), prognosis was conditioned by the underlying severity of cardiac disease (i.e., New York Heart Association class III-IV, decreasing blood pressure, presence of atrial fibrillation and severe mitral regurgitation), whereas increasing age showed no sign of predicting all-cause or cardiovascular mortality (both p > or = 0.4). In HT recipients, age did not retain significance at multivariate analysis as an independent predictor (p > or = 0.14 for both all-cause and cardiovascular death), whereas ischemic etiology of pre-existing CHF did (p < or = 0.02).
  
  
  CONCLUSIONS
  Age did not appear to be a primary determinant of all-cause or cardiovascular mortality among potential HT candidates or eventual recipients (ischemic etiology of CHF turned out to be the major determinant of post-transplant outcome). These results support the concept that HT may be considered a treatment option in patients with more advanced age strata, particularly when affected by non-ischemic cardiomyopathy.
authors.affiliation: Cardiovascular Department, The University of Bologna, Bologna, Italy. francesco.grigioni@unibo.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Grigioni
authors.forename: Luciano
authors.initials: L
authors.lastname: Potena
authors.forename: Andrea
authors.initials: A
authors.lastname: Barbieri
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bianchi
authors.forename: Letizia
authors.initials: L
authors.lastname: Reggianini
authors.forename: Antonio
authors.initials: A
authors.lastname: Russo
authors.forename: Francesco
authors.initials: F
authors.lastname: Fallani
authors.forename: Gaia
authors.initials: G
authors.lastname: Magnani
authors.forename: Fabio
authors.initials: F
authors.lastname: Coccolo
authors.forename: Giorgio
authors.initials: G
authors.lastname: Arpesella
authors.forename: Claudio
authors.initials: C
authors.lastname: Rapezzi
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Modena
authors.forename: Angelo
authors.initials: A
authors.lastname: Branzi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D016027:Heart Transplantation / Q000401:mortality*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies