(789) - Heart Transplantation in Seniors: The Impact of Age on Outcomes?

Abstract

The proportion of older recipients is constantly rising in heart transplantation. Although ISHLT registry data indicates that increasing age is a strong independent risk factor for survival, a number of single-center and multicenter reports suggest favorable outcomes in senior population. It is of interest to know the impact of age of recipients on outcomes in cardiac transplantation. We report our experience in this particular patient population. We retrospectively analyzed 398 orthotopic cardiac transplants in our transplant center from 1994 to 2015. Survival and predictors of outcome were analyzed. A total of 166 senior recipients (older than 55 years) were identified from 398 transplants. A rising proportion of older recipients were appreciated by year. 7 patients in the group of over 70 years showed a 100% 1 and 5 year survival, and 10 year survival at 51.6%. Patients of 65-70 years also demonstrated superior outcome than their younger counterparts with 1, 5, 10 year survival at 88.5%, 77.7% and 55.5% (see figure 1). By dividing the recipients into different age groups as outlined in table 1, we analyzed their pre-transplant kidney, liver function and nutrition status which demonstrated no significant difference. Age alone should not be a contraindication for heart transplantation. Carefully selection of transplant candidates can achieve good outcomes. Application of frailty index into current pre-transplant evaluation for senior recipients may be helpful for risk stratification.Tabled 1Table 1. Summary of demographic and lab values for each age group50<=Age<6060<=Age<6565<=Age<7070<=AgeTotalN=70N=58N=33N=5N=166p valueAgeMean (SD)57.4 (1.4)62.3 (1.5)66.9 (1.5)71.7 (1.7)61.4 (4.3)Gender0.1400F18 (25.7%)12 (20.7%)2 (6.1%)1 (20.0%)33 (19.9%)M52 (74.3%)46 (79.3%)31 (93.9%)4 (80.0%)133 (80.1%)Race0.3834Black3 (4.3%)2 (3.4%)1 (3.0%)0 (0.0%)6 (3.6%)Other2 (2.9%)4 (6.9%)0 (0.0%)1 (20.0%)7 (4.2%)White65 (92.9%)52 (89.7%)32 (97.0%)4 (80.0%)153 (92.2%)Bilirubin0.3927Mean (SD)1.1 (0.9)0.8 (0.5)1.0 (0.7)1.0 (0.4)1.0 (0.7)Albumin0.8017Mean (SD)5.1 (5.7)4.1 (0.5)4.1 (0.5)4.0 (0.5)4.5 (3.8)Creatinine0.2278Mean (SD)1.2 (0.4)1.3 (0.5)1.3 (0.4)1.1 (0.3)1.3 (0.4) Open table in a new tab