The influence of donor age on transplant coronary artery disease and survival post heart transplantation: is it safe to extend donor age?

Transplant Proc. 2004 Dec;36(10):3139-41. doi: 10.1016/j.transproceed.2004.12.007.

Abstract

Background: Due to the increasing demand for suitable cardiac donor organs, acceptance criteria need to be re-evaluated. We retrospectively analyzed the effect of donor age on survival following cardiac transplantation.

Method: Three hundred thirty-five cardiac transplant recipients and corresponding donor data were reviewed using SPSS.

Results: Seventy-two recipients had early posttransplant angiography or postmortem data available. The mean donor age of recipients with evidence of graft coronary artery disease (32.5 +/- 11.7 years) was significantly higher than that of recipients free of transplant coronary artery disease (TCAD) (24.8 +/- 9.4 years; P=.003). Recipient of organs from donors aged less than 50 years were less likely to develop TCAD than those of donors aged over 50 years (odds ratio 0.333; 95% CI 0.239-0.465; P=.044). TCAD also occurred much earlier posttransplantation in recipients of organ from donors over 50 years (mean time 6.5 years; median 5.0 years) than those of donors under 50 years (mean time 12.7 years; median 14.0 years).

Conclusion: We observed no increase in mortality associated with cardiac donors over 50 years. However, increased donor age was associated with an increased incidence of TCAD.

MeSH terms

  • Adult
  • Age Factors*
  • Coronary Angiography
  • Coronary Disease / diagnostic imaging
  • Coronary Disease / physiopathology*
  • Coronary Disease / surgery
  • Follow-Up Studies
  • Heart Transplantation / mortality
  • Heart Transplantation / physiology*
  • Humans
  • Medical Records
  • Middle Aged
  • Retrospective Studies
  • Survival Analysis
  • Time Factors
  • Treatment Outcome