Survival after heart transplant similar between older, young
At 5 years, survival rates after heart transplant were noninferior in older patients compared with younger patients, according to new data published in the Journal of the American Geriatrics Society.

To examine if older age (more than 70 years) should be a relative contraindication for heart transplantation, this study evaluated the characteristics and outcomes of patients with age more than 70 years listed for heart transplantation; and whether post-transplantation survival was inferior to younger counterparts.

Participants were adults (more than 18 years) listed for heart transplantation in the SRTR between 2000 and 2018.

Characteristics and outcomes were compared for adults more than 70 years and less than 70 years. Researchers evaluated waitlist mortality and post-transplant 1-year and 5-year survivals.

-- The study included 57,285 patients (age range 18–79 years) listed for heart transplantation; 1203 (2.1%) age more than 70 years.

-- Of these, 37,135 patients underwent heart transplantation; 806 (2.2%) were age more than 70 years.

-- Yearly listing of those age more than 70 years has consistently increased from 2.5% (n =30) in 2000 to 11% (n =132) in 2017.

-- As compared with the age less than 70 years group, those more than 70 years had a similar risk of death while waiting but were more likely to be transplanted.

-- Among the older patients, the overall post-transplant 1- and 5-year mortality rate was 10.4% and 19.2%, respectively.

-- Older recipients had lower unadjusted survival compared with younger recipients.

-- However, after adjustment for relevant covariates, there was no significant difference in 5-year mortality between both groups.

Conclusively, post-transplant survival up to 5 years among patients of age more than 70 years was similar to that of younger recipients. Older patients who received heart transplantation appear to have lower risk features but receive hearts from higher risk donors. Chronologic age alone should not constitute a contraindication for heart transplantation, although careful patient selection criteria should be applied.