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Ann Thorac Surg 1996;62:1578-1579
© 1996 The Society of Thoracic Surgeons

Editorial

Should Cardiac Transplantation Be Offered to Septuagenarians?

Wayne E. Richenbacher, MD

Division of Cardiothoracic Surgery, The University of Iowa Hospitals and Clinics, Iowa City, Iowa

The first 20% of the full text of this article appears below.

Recipient and donor selection criteria were originally developed to minimize the morbidity and mortality of early cardiac transplantation. With the introduction of cyclosporine to immunosuppressive regimens in the early 1980s, the incidences of infection and rejection decreased in the cardiac transplant recipient patient population. The attendant improvement in early and late survival led to utilization of what were previously defined as high-risk cardiac donors, and the extension of heart transplantation to patients who did not comply with traditional selection criteria. In this issue of The Annals of Thoracic Surgery, Blanche and colleagues [1] describe their experience with cardiac transplantation in 6 patients 70 years of age and older. All 6 patients survived the cardiac transplantation and are reported to be clinically well with normal cardiac function at a mean follow-up time of 9 months. When considering offering cardiac transplantation to septuagenarians, two questions must be answered. First, can cardiac transplantation be successfully performed in the elderly; and second, should cardiac transplantation be offered to the elderly?

See also page 1731.

Originally, cardiac transplantation was offered to patients less than 50 to 55 years of age. According to the United Network for Organ Sharing database, only 1.4% of patients (24 of 1,676) who underwent cardiac transplantation in 1988 were more than 65 years old [2]. In 1994, however, that rate had nearly tripled; 4.1% of the patients (97 of 2,340) who underwent a heart transplant were more than 65 years of age. Increasingly, cardiac transplantation has been offered to older patients as short-term results approach those achieved in younger patients [5–5]. In 1988, Frazier and colleagues [5] described their experience with 28 cardiac transplant recipients more than 60 years of . . . [Full Text of this Article]


Related Article

Heart Transplantation in Patients 70 Years of Age and Older: Initial Experience
Carlos Blanche, Jack M. Matloff, Timothy A. Denton, Lawrence S. C. Czer, Michael C. Fishbein, Johanna J. M. Takkenberg, and Alfredo Trento
Ann. Thorac. Surg. 1996 62: 1731-1736. [Abstract] [Full Text]





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