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Effect of Donor Age on Long‐Term Survival Following Cardiac Transplantation
Author(s) -
Topkara Veli K.,
Cheema Faisal H.,
Kesavaramanujam Satish,
Mercando Michelle L.,
Forster Catherine S.,
Argenziano Michael,
Esrig Barry C.,
Oz Mehmet C.,
Naka Yoshifumi
Publication year - 2006
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2006.00189.x
Subject(s) - medicine , transplantation , economic shortage , population , body mass index , multivariate analysis , diabetes mellitus , surgery , endocrinology , linguistics , philosophy , environmental health , government (linguistics)
Background and Aim: The current shortage of donor hearts has forced the criteria of organ procurement to be extended, leading to increased use of older donor hearts to bridge the gap between demand and availability. Our objective was to analyze the effect of donor age on outcomes after cardiac transplantation. Methods: We retrospectively studied 864 patients who underwent cardiac transplantation at New York Presbyterian Hospital – Columbia University between 1992 and 2002. Patients were divided into two groups; donor age <40 years (Group A, n = 600) and donor age ≥40 years (Group B, n = 264). Results: Characteristics including gender, body mass index, and cytomegalovirus (CMV) status were significantly different between the two donor age groups. Race, CMV status, toxoplasmosis status, left ventricular assist device prior to transplant, diabetes mellitus, and retransplantation were similar in both the recipient groups, while age, gender, and BMI were different. Early mortality was lower in Group A, 5%, versus 9.5% in Group B. Multivariate analysis revealed recipient female gender (odd ratio (OR) = 1.71), retransplantation (OR = 1.63), and increased donor age (OR = 1.02) as significant predictors of poor survival in the recipient population. Actuarial survival at 1 year (86.7% vs 81%), 5 years (75% vs 65%), and 10 years (56% vs 42%) was significantly different as well with a log rank p = 0.002. Conclusions: These findings suggest that increased donor age is an independent predictor of long‐term survival. However, the shortage of organs makes it difficult to follow strict guidelines when placing hearts; therefore, decisions need to be made on a relative basis.