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Age and heart transplantation: results from a heart failure management unit
Author(s) -
Grigioni Francesco,
Potena Luciano,
Barbieri Andrea,
Bianchi Giorgio,
Reggianini Letizia,
Russo Antonio,
Fallani Francesco,
Magnani Gaia,
Coccolo Fabio,
Arpesella Giorgio,
Rapezzi Claudio,
Modena Maria Grazia,
Branzi Angelo
Publication year - 2007
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2007.00759.x
Subject(s) - medicine , heart transplantation , heart failure , transplantation , intensive care medicine , management of heart failure , cardiology
Background: More evidence is needed to assess the pros and cons of maintaining age‐limit policies in heart transplantation (HT). Methods: We analyzed clinical data from a heart failure management unit to investigate the impact of age on prognosis of two distinct cohorts: (i) 309 patients (median age, 57 yr; 62% male) with severe chronic heart failure (CHF) consecutively screened for HT; (ii) 336 HT recipients (median age 56 yr, 82% male). Results: In CHF patients (screened for HT), prognosis was conditioned by the underlying severity of cardiac disease (i.e., New York Heart Association class III–IV, decreasing blood pressure, presence of atrial fibrillation and severe mitral regurgitation), whereas increasing age showed no sign of predicting all‐cause or cardiovascular mortality (both p ≥ 0.4). In HT recipients, age did not retain significance at multivariate analysis as an independent predictor (p ≥ 0.14 for both all‐cause and cardiovascular death), whereas ischemic etiology of pre‐existing CHF did (p ≤ 0.02). Conclusions: Age did not appear to be a primary determinant of all‐cause or cardiovascular mortality among potential HT candidates or eventual recipients (ischemic etiology of CHF turned out to be the major determinant of post‐transplant outcome). These results support the concept that HT may be considered a treatment option in patients with more advanced age strata, particularly when affected by non‐ischemic cardiomyopathy.