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Heart Transplant Outcomes Comparable in Advanced Age

WEDNESDAY, June 9, 2021 -- Survival up to five years after a heart transplant is similar for patients aged 70 years and older and those younger than 70 years, according to a study published online June 9 in the Journal of the American Geriatrics Society.

Abhishek Jaiswal, M.D., from the Hartford Hospital in Connecticut, and colleagues compared characteristics and outcomes for adults aged 70 years and older and younger than 70 years in a retrospective cohort analysis involving 57,285 adults listed for heart transplantation between 2000 and 2018. Overall, 37,135 patients underwent heart transplantation, of whom 2.2 percent were aged 70 years and older.

The researchers observed an increase in the yearly listing of those aged 70 years and older, from 2.5 to 11 percent in 2000 and 2017. Those aged 70 years and older had a similar risk for death while waiting as those younger than 70 years (subhazard ratio, 0.86; 95 percent confidence interval, 0.68 to 1.08; P = 0.19), but they had an increased likelihood of being transplanted (subhazard ratio, 1.36; 95 percent confidence interval, 1.26 to 1.48; P < 0.01). The overall posttransplant one- and five-year mortality rates were 10.4 and 19.2 percent, respectively, among the older patients. Compared with younger recipients, older recipients had lower unadjusted survival. After adjustment for relevant confounding variables, no significant between-group difference was seen in five-year mortality (hazard ratio, 1.06; 95 percent confidence interval, 0.91 to 1.254; P = 0.43).

"Our data suggest that advanced age by itself should not be considered an ineligibility criteria for heart transplantation; however, careful selection of such patients is warranted," Jaiswal said in a statement.

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