(1196) - Donor Age Significantly Impacts Long Term Survival of Patients Undergoing Heart Transplantation

Abstract

Purpose The scarcity of donors has led to use of older donor hearts for transplantation (HT). The impact of donor age on patient survival after heart transplant does not usually impact short to medium range survival. We analyzed the association of donor age with long-term patient survival after HT. Methods We retrospectively reviewed 755 patients undergoing HT at our institution from 05/1984 to 07/2018. Kaplan-Meier curves and Cox proportional hazard models were created to compare survival among patients who received hearts from donors Results The 2 groups were comparable with regard to recipient's age, gender and ischemic time. Median donor age for g1 was 24 years (Interquartile range [IQR]: 19-33) and for g2 was 50 years (IQR: 48-52). During follow up, (median 7 years; IQR 2-9.5), 229 (36%) patients died in g1 and 49 (52%) patients died from g2. Survival of patients receiving hearts from donors ≥45 years old was significantly lower compared to patients receiving hearts from younger donors (p=0.018; Figure 1). In multivariate Cox models using donor age as a continuous variable, risk of recipients' death was significantly higher with increasing donor age (HR 1.02, CI 1.01-1.02; p Conclusion Higher donor age was associated with greater risk of recipients’ death after cardiac transplant. Careful selection of older donor hearts to selected recipients may ameliorate the differences in long term survival.