Use of Donor Hearts ≥50 Years Old for Septuagenarians in Heart Transplantation

Authors

Suguru Ohira, Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, Valhalla, New York; New York Medical College, Valhalla, New York. Electronic address: suguru.ohira@wmchealth.org.
Kenji Okumura, Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, Valhalla, New York.
Rahim Hirani, New York Medical College, Valhalla, New York.
Sabrina Martinez, New York Medical College, Valhalla, New York.
Hajime Ichikawa, Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, Valhalla, New York.
Ameesh Isath, Department of Cardiology, Westchester Medical Center, Valhalla, New York.
Gregg M. Lanier, Department of Cardiology, Westchester Medical Center, Valhalla, New York.
Corazon De La Pena, Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, Valhalla, New York.
David Spielvogel, Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, Valhalla, New York; New York Medical College, Valhalla, New York.
Masashi Kai, Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, Valhalla, New York; New York Medical College, Valhalla, New York.

Author Type(s)

Resident/Fellow, Student, Faculty

Journal Title

The Annals of Thoracic Surgery

First Page

580

Last Page

586

Document Type

Article

Publication Date

9-1-2023

Department

Surgery

Second Department

Medicine

Abstract

BACKGROUND: The impact of using donors ≥50 years old on heart transplantation outcomes of septuagenarians is unknown, which may have a potential to expand the donor pool. METHODS: From January 2011 to December 2021, 817 septuagenarians received donor hearts <50 years old (DON<50) and 172 septuagenarians received donor hearts ≥50 years old (DON≥50) in the United Network for Organ Sharing database. Propensity score matching was performed using recipient characteristics (167 pairs). The Kaplan-Meier method and Cox proportional hazards model were used to analyze death and graft failure. RESULTS: The number of heart transplants in septuagenarians has been increasing (54 per year in 2011 to 137 per year in 2021). In a matched cohort, the donor age was 30 years in DON<50 and 54 years in DON≥50. In DON≥50, cerebrovascular disease was the main cause of death (43%), whereas head trauma (38%) and anoxia (37%) were the causes in DON<50 (P < .001). The median heart ischemia time was comparable (DON<50, 3.3 hours; DON≥50, 3.2 hours; P = .54). In matched patients, 1- and 5-year survival rates were 88.0% (DON<50) vs 87.2% (DON≥50) and 79.2% (DON<50) vs 72.3% (DON≥50), respectively (log-rank, P = .41). In the multivariable Cox proportional hazards models, donors ≥50 years old were not associated with death in matched (hazard ratio, 1.05; 95% CI, 0.67-1.65; P = .83) and nonmatched groups (hazard ratio, 1.11; 95% CI, 0.82-1.50; P = .49). CONCLUSIONS: The use of donor hearts older than 50 years can be an effective option for septuagenarians, thereby potentially increasing organ availability without compromising outcomes.

Recommended Citation

Ohira, S., Okumura, K., Hirani, R., Martinez, S., Ichikawa, H., Isath, A., Lanier, G. M., De La Pena, C., Spielvogel, D., & Kai, M. (2023). Use of Donor Hearts ≥50 Years Old for Septuagenarians in Heart Transplantation. The Annals of Thoracic Surgery, 116 (3), 580-586. https://doi.org/10.1016/j.athoracsur.2023.04.032