Heart Transplantation of the Elderly—Old Donors for Old Recipients: Can We Still Achieve Acceptable Results?
As society is ageing, an increasing prevalence of elderly heart failure patients will be expected. In order to increase the donor pool, acceptance of older donors might be a reasonable choice. All patients undergoing heart transplantation between 2010 and 2021 at a single department were retrospecti...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-02-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/11/4/929 |
| _version_ | 1797479164477964288 |
|---|---|
| author | Moritz Benjamin Immohr Hug Aubin Ralf Westenfeld Sophiko Erbel-Khurtsidze Igor Tudorache Payam Akhyari Artur Lichtenberg Udo Boeken |
| author_facet | Moritz Benjamin Immohr Hug Aubin Ralf Westenfeld Sophiko Erbel-Khurtsidze Igor Tudorache Payam Akhyari Artur Lichtenberg Udo Boeken |
| author_sort | Moritz Benjamin Immohr |
| collection | DOAJ |
| description | As society is ageing, an increasing prevalence of elderly heart failure patients will be expected. In order to increase the donor pool, acceptance of older donors might be a reasonable choice. All patients undergoing heart transplantation between 2010 and 2021 at a single department were retrospectively reviewed and divided into different study groups with regard to recipient (≤60 years (R<sup>Y</sup>) or >60 years (R<sup>O</sup>)) and donor age (≤50 years (D<sup>Y</sup>) or >50 years (D<sup>O</sup>). A total of <i>n</i> = 201 patients were included (D<sup>Y</sup>/R<sup>Y</sup>, <i>n</i> = 91; D<sup>O</sup>/R<sup>Y</sup>, <i>n</i> = 38; D<sup>Y</sup>/R<sup>O</sup>, <i>n</i> = 41; D<sup>O</sup>/R<sup>O</sup>, <i>n</i> = 31). Neither incidence of severe primary graft dysfunction (<i>p</i> = 0.64) nor adverse events, such as kidney failure (<i>p</i> = 0.27), neurological complications (<i>p</i> = 0.63), infections (<i>p</i> = 0.21) or acute graft rejection (<i>p</i> = 1.00), differed between the groups. However, one-year survival was impaired in the D<sup>O</sup>/R<sup>O</sup> group (56.0%) compared to the other groups (D<sup>Y</sup>/R<sup>Y</sup>: 86.1%, D<sup>Y</sup>/R<sup>O</sup>: 78.8%, D<sup>O</sup>/R<sup>Y</sup>: 74.2%, <i>p</i> = 0.02). Given the impaired one-year survival, acceptance of grafts from old donors for old recipients should be performed with caution and by experienced centres only. Nevertheless, because of the otherwise dismal prognosis of elderly heart failure patients, transplantation of patients may still improve the therapy outcome. |
| first_indexed | 2024-03-09T21:42:16Z |
| format | Article |
| id | doaj.art-88e8f45ea8374e7599b21a2acbd38968 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T21:42:16Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-88e8f45ea8374e7599b21a2acbd389682023-11-23T20:29:00ZengMDPI AGJournal of Clinical Medicine2077-03832022-02-0111492910.3390/jcm11040929Heart Transplantation of the Elderly—Old Donors for Old Recipients: Can We Still Achieve Acceptable Results?Moritz Benjamin Immohr0Hug Aubin1Ralf Westenfeld2Sophiko Erbel-Khurtsidze3Igor Tudorache4Payam Akhyari5Artur Lichtenberg6Udo Boeken7Department of Cardiac Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, GermanyDepartment of Cardiac Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, GermanyDivision of Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, GermanyDepartment of Cardiac Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, GermanyDepartment of Cardiac Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, GermanyDepartment of Cardiac Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, GermanyDepartment of Cardiac Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, GermanyDepartment of Cardiac Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, GermanyAs society is ageing, an increasing prevalence of elderly heart failure patients will be expected. In order to increase the donor pool, acceptance of older donors might be a reasonable choice. All patients undergoing heart transplantation between 2010 and 2021 at a single department were retrospectively reviewed and divided into different study groups with regard to recipient (≤60 years (R<sup>Y</sup>) or >60 years (R<sup>O</sup>)) and donor age (≤50 years (D<sup>Y</sup>) or >50 years (D<sup>O</sup>). A total of <i>n</i> = 201 patients were included (D<sup>Y</sup>/R<sup>Y</sup>, <i>n</i> = 91; D<sup>O</sup>/R<sup>Y</sup>, <i>n</i> = 38; D<sup>Y</sup>/R<sup>O</sup>, <i>n</i> = 41; D<sup>O</sup>/R<sup>O</sup>, <i>n</i> = 31). Neither incidence of severe primary graft dysfunction (<i>p</i> = 0.64) nor adverse events, such as kidney failure (<i>p</i> = 0.27), neurological complications (<i>p</i> = 0.63), infections (<i>p</i> = 0.21) or acute graft rejection (<i>p</i> = 1.00), differed between the groups. However, one-year survival was impaired in the D<sup>O</sup>/R<sup>O</sup> group (56.0%) compared to the other groups (D<sup>Y</sup>/R<sup>Y</sup>: 86.1%, D<sup>Y</sup>/R<sup>O</sup>: 78.8%, D<sup>O</sup>/R<sup>Y</sup>: 74.2%, <i>p</i> = 0.02). Given the impaired one-year survival, acceptance of grafts from old donors for old recipients should be performed with caution and by experienced centres only. Nevertheless, because of the otherwise dismal prognosis of elderly heart failure patients, transplantation of patients may still improve the therapy outcome.https://www.mdpi.com/2077-0383/11/4/929heart transplantationageelderlyfrailtydemographic change |
| spellingShingle | Moritz Benjamin Immohr Hug Aubin Ralf Westenfeld Sophiko Erbel-Khurtsidze Igor Tudorache Payam Akhyari Artur Lichtenberg Udo Boeken Heart Transplantation of the Elderly—Old Donors for Old Recipients: Can We Still Achieve Acceptable Results? Journal of Clinical Medicine heart transplantation age elderly frailty demographic change |
| title | Heart Transplantation of the Elderly—Old Donors for Old Recipients: Can We Still Achieve Acceptable Results? |
| title_full | Heart Transplantation of the Elderly—Old Donors for Old Recipients: Can We Still Achieve Acceptable Results? |
| title_fullStr | Heart Transplantation of the Elderly—Old Donors for Old Recipients: Can We Still Achieve Acceptable Results? |
| title_full_unstemmed | Heart Transplantation of the Elderly—Old Donors for Old Recipients: Can We Still Achieve Acceptable Results? |
| title_short | Heart Transplantation of the Elderly—Old Donors for Old Recipients: Can We Still Achieve Acceptable Results? |
| title_sort | heart transplantation of the elderly old donors for old recipients can we still achieve acceptable results |
| topic | heart transplantation age elderly frailty demographic change |
| url | https://www.mdpi.com/2077-0383/11/4/929 |
| work_keys_str_mv | AT moritzbenjaminimmohr hearttransplantationoftheelderlyolddonorsforoldrecipientscanwestillachieveacceptableresults AT hugaubin hearttransplantationoftheelderlyolddonorsforoldrecipientscanwestillachieveacceptableresults AT ralfwestenfeld hearttransplantationoftheelderlyolddonorsforoldrecipientscanwestillachieveacceptableresults AT sophikoerbelkhurtsidze hearttransplantationoftheelderlyolddonorsforoldrecipientscanwestillachieveacceptableresults AT igortudorache hearttransplantationoftheelderlyolddonorsforoldrecipientscanwestillachieveacceptableresults AT payamakhyari hearttransplantationoftheelderlyolddonorsforoldrecipientscanwestillachieveacceptableresults AT arturlichtenberg hearttransplantationoftheelderlyolddonorsforoldrecipientscanwestillachieveacceptableresults AT udoboeken hearttransplantationoftheelderlyolddonorsforoldrecipientscanwestillachieveacceptableresults |