title: Impact of donor age on cardiac transplantation outcomes and on cardiac function.
abstract: Although the impact of older donors on heart transplant outcomes has been previously published, the survival results are conflicting. We herein analyse the impact of older donors on transplant survival and myocardial function.
  
  
  
  The records of the patients who underwent heart transplant at Baylor University Medical Center at Dallas from November 2012 until March 2015 were reviewed and the data were extracted. The heart recipients were divided into two groups based on donors age; 50 years of age was the division point. The two groups were compared with regard to the following transplant outcomes: in-hospital and 1-year survival, severe (3R) rejection, primary graft dysfunction, myocardial performance as reflected by the inotropic score, left ventricular ejection fraction, intensive care unit and overall length of stay.
  
  
  
  Anoxia was more common cause of death in younger donors (43.9%), whereas intracranial bleeding was more frequent in older donors (48.1%, P = 0.016). The in-hospital survival and 1-year survival were the same between the two groups. Additionally, cardiac transplantation from older donors was not associated with higher incidence of graft dysfunction, higher inotropic support score, longer intensive care unit and total hospital length of stay or more frequent severe rejection episodes. The left ventricular ejection fraction was similar between the two groups.
  
  
  
  Heart transplant from older donors is not associated with lower in-hospital and mid-term survival if donors are carefully selected; furthermore, the graft function is comparable. The use of hearts from donors older than 50 years of age can be expanded beyond critically ill recipients in carefully selected recipients.
authors.affiliation: Department of Thoracic and Cardiac Surgery, Baylor University Medical Center at Dallas, Dallas, TX, USA themistokles.chamogeorgakis@baylorhealth.edu.
authors.forename: Themistokles
authors.initials: T
authors.lastname: Chamogeorgakis
authors.affiliation: Department of Cardiology, Baylor University Medical Center at Dallas, Dallas, TX, USA.
authors.forename: Susie
authors.initials: S
authors.lastname: Joseph
authors.affiliation: Department of Cardiology, Baylor University Medical Center at Dallas, Dallas, TX, USA.
authors.forename: Shelley
authors.initials: S
authors.lastname: Hall
authors.affiliation: Department of Thoracic and Cardiac Surgery, Baylor University Medical Center at Dallas, Dallas, TX, USA.
authors.forename: Gonzalo V
authors.initials: GV
authors.lastname: Gonzalez-Stawinski
authors.affiliation: Annette and Harold Simmons Transplant Institute, Dallas, TX, USA.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Saracino
authors.affiliation: Department of Thoracic and Cardiac Surgery, Baylor University Medical Center at Dallas, Dallas, TX, USA.
authors.forename: Aldo
authors.initials: A
authors.lastname: Rafael
authors.affiliation: Department of Thoracic and Cardiac Surgery, Baylor University Medical Center at Dallas, Dallas, TX, USA.
authors.forename: Juan
authors.initials: J
authors.lastname: MacHannaford
authors.affiliation: National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Toumpoulis
authors.affiliation: Department of Cardiology, Baylor University Medical Center at Dallas, Dallas, TX, USA.
authors.forename: Jose
authors.initials: J
authors.lastname: Mendez
authors.affiliation: Department of Thoracic and Cardiac Surgery, Baylor University Medical Center at Dallas, Dallas, TX, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Lima
mesh_terms: D000368:Aged; D002423:Cause of Death / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology* / Q000503:physiopathology; D006085:Graft Survival; D006333:Heart Failure / Q000401:mortality / Q000601:surgery*; D016027:Heart Transplantation / Q000401:mortality*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D055031:Primary Graft Dysfunction / Q000453:epidemiology* / Q000503:physiopathology; D011379:Prognosis; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology*; D015996:Survival Rate / Q000639:trends; D013781:Texas / Q000453:epidemiology; D014019:Tissue Donors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: Cardiac transplantation; Older donor; Outcomes