Patients 60 years of age and older should have the same chance for heart transplantation or not?

Summary

Heart transplantation is considered the best treatment modality for advanced heart disease. While old age has conventionally been considered a contraindication for heart transplantation due to the reported adverse effect of advanced age, however donor hearts’ shortage continues to stimulate the discussion about the recipient’s upper age limit. Our study was based on a retrospective analysis for the results of 52 (18%) patients aged 60 years and older undergoing heart transplantation between May 2008 and December 2015, and these patients were compared with 236 (82%) adult recipients who were younger than 60 years at the time of transplantation and during the same period. In older group, 71% were males with the mean age of 63.38±3.55 years, and in younger group, 83.4% were males with a mean age of 43.72±11.41 years (P=0.27). Dilated cardiomyopathy was the most common indication for transplantation among patients in both groups (P=0.147). In older group, the 3-month survival rate was higher than that in younger group (P=0.587), however the 6-month survival rate showed no significant difference (P=0.225). Although the 1-year survival rate was higher in older group (P=0.56), yet the 3-year survival rate between the two groups showed no statistically significant difference (P=0.48). According to our experience among older heart transplant candidates who were 60 years and older, we believe that advanced age should not be an excluding criterion to cardiac transplantation.