Orthotopic heart transplantation with donors greater than or equal to 60 years of age: a single-center experience
| Autor: | Aldo Cannata, Luca Botta, Luigi Martinelli, Fabrizio Oliva, Tiziano Colombo, Nuccia Morici, Maria Frigerio, Giuseppe Bruschi |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Graft Rejection Male Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.medical_treatment Cardiomyopathy Single Center Donor Selection Humans Medicine Aged Cause of death Heart Failure Heart transplantation business.industry Donor selection Incidence (epidemiology) Age Factors General Medicine Middle Aged Prognosis medicine.disease Tissue Donors Surgery Transplantation Treatment Outcome Heart failure Heart Transplantation Female Epidemiologic Methods Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 40:e55-e61 |
| ISSN: | 1010-7940 |
| DOI: | 10.1016/j.ejcts.2011.02.013 |
| Popis: | Objectives: Heart transplantation is the best therapeutic option for patients suffering from end-stage heart failure, but donor organ availability still represents a major problem. This had led to a shift toward extended donor criteria. The aim of the present study is to analyze the short- and long-term results of heart transplantation in patients with donor age 60 years. Methods: Since November 1985, 890 patients have been transplanted at our center. We consider, for the present study, only primary adult heart transplantations performed after 1990, totaling 761 patients, mean age at transplantation 49.8 years, and 616 patients being male (81%). We compare the short- and long-term results of patients transplantedwithdonorsyoungerthan60 yearsor60 years.Results:Since1990,at ourcenter, 711patientshavebeenheart transplantedwith a donor younger than 60 years, while 50 patients received a heart from a donor older than 60 years. No differences have been reported in the etiology of cardiomyopathy, previous surgery, or mean ischemic time. Patients transplanted with donors 60 years of age were significantly older compared to the younger donors’ group. Donor cause of death was a cerebrovascular accident in 82% of donors 60 years versus 41% in younger donors. Patients’ heart transplanted with donors 60 years had a higher incidence of acute graft failure with a hospital mortality of 32% (16 patients) significantly higher compared with 10.2% for the other group. No differences were noticed in the incidence of renal failure, acute rejection treated, coronary allograft vasculopathy, and neoplasm during long-term follow-up. Conclusions: It was possible to expand the cardiac donor pool by accepting allografts from donors 60 years of age in selected cases by performing a coronary angiogram. A meticulous donor evaluation and a careful risk assessment between the risk of death on the waiting list and probable increased hospital mortality are needed. # 2011 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved. |
| Databáze: | OpenAIRE |
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