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DOI: 10.1055/s-0035-1544542
Usage of Older Organs for Heart Transplantation as an Option to Expand Donor Pool
Objectives: Despite numerous potential options, the most effective immediate solution for an increased donor pool is the expansion of acceptance criteria for donor age and medical condition. We aimed to compare the outcome after HTx with regard to the age of donor organs.
Methods: Between 2011 and August 2014, 10 patients underwent htx in our department using donor hearts 60 years of age and (group 1). Those were compared with 36 patients receiving younger donor organs (gr.2).
Results: We did not find differences between the groups with regard to epidemiologic data, comorbidities, clinical status and transplant status at transplantation. Donor criteria, including ejection fraction, CMV status, time of ischemia as well as sex were also comparable.
30-day mortality was similar in the groups (10% in gr.1 vs 13.9% in gr.2; p > 0.05). Survival after 1 and 2 years also did not differ significantly. In both groups there were 2 patients requiring additional CABG during htx (p < 0.05). During follow-up, coronary artery vasculopathy occurred in 1 patient in gr. 1, not in group 2. There were no patients requiring re-htx.
After 1 year, ejection fraction was satisfying in both groups. Midterm cardiac morbidity was lower in group II (p = 0.04). However, there was only one CMV-infection during follow-up in gr. 2 (2.8% versus 0 in gr.1). Freedom from rejection episodes (> °1R) was similar.
Conclusions: Donor age did not significantly influence midterm outcome after htx. Carefully selected, older donor hearts can be used for heart transplantation with survival and outcome similar to those of younger donor organs.