Long-term results of cardiac transplantation in patients older than sixty years

D. A. Bull, S. V. Karwande, J. A. Hawkins, L. A. Neumayer, D. O. Taylor, K. W. Jones, D. G. Renlund, C. W. Putnam, R. C. Robbins

Research output: Contribution to journalArticle

38 Scopus citations

Abstract

Advanced age has traditionally been a contraindication to cardiac transplantation. We have, however, offered cardiac transplantation to patients older than 60 years with end-stage heart failure if they were otherwise acceptable candidates. From 1985 to 1994, 527 patients underwent cardiac transplantation. Among these patients, 101 were older than 60 years at transplantation. The mean follow-up of this group is 6 years. Patients older than 60 years had significantly fewer rejection episodes per patient than those who were younger than 60 years at transplantation (1.9 ± 1.3 vs 2.6 ± 1.8, p = 0.009). No difference in the number of infectious complications per patient was detected between the two groups. Both short- term and long-term survival after transplantation were significantly lower for patients who were older than 60 years at transplantation than for younger patients (p < 0.05). The 6-year actuarial survival after transplantation for patients older than 60 years was 54% compared with 72% for patients younger than 60 years at transplantation (p < 0.05). Patients older than 60 years at transplantation were more likely to die of infectious complications or malignant disease after transplantation (p < 0.05). We believe caution is warranted in offering cardiac transplantation to patients older than 60 years. This group of patients should be carefully observed for the development of potentially life-threatening infectious complications or new malignant tumors after transplantation.

Original languageEnglish (US)
Pages (from-to)423-428
Number of pages6
JournalJournal of Thoracic and Cardiovascular Surgery
Volume111
Issue number2
DOIs
StatePublished - Jan 1 1996
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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    Bull, D. A., Karwande, S. V., Hawkins, J. A., Neumayer, L. A., Taylor, D. O., Jones, K. W., Renlund, D. G., Putnam, C. W., & Robbins, R. C. (1996). Long-term results of cardiac transplantation in patients older than sixty years. Journal of Thoracic and Cardiovascular Surgery, 111(2), 423-428. https://doi.org/10.1016/S0022-5223(96)70452-X