Is Age a Limiting Factor for Access to Transplantation?

Abstract As a result of increased life expectancy and quality of life, there is an increasing number of patients older than 65 years of age who require the possibility of heart transplantation (HTx). Traditionally, recipient age older than 65 years has been considered a contraindication for performi...

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Bibliographic Details
Published in:Transplantation proceedings 2011-07, Vol.43 (6), p.2151-2153
Main Authors: Almenar-Bonet, L, Sánchez-Lázaro, I.J, Martínez-Dolz, L
Format: Article
Language:English
Subjects:
Age Factors
Aged
Biological and medical sciences
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Graft Rejection - immunology
Graft Rejection - prevention & control
Graft Survival
Health Services Accessibility
Heart Transplantation - adverse effects
Heart Transplantation - immunology
Humans
Immunosuppressive Agents - therapeutic use
Medical sciences
Patient Selection
Risk Assessment
Risk Factors
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Time Factors
Tissue Donors - supply & distribution
Tissue, organ and graft immunology
Treatment Outcome
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Summary:Abstract As a result of increased life expectancy and quality of life, there is an increasing number of patients older than 65 years of age who require the possibility of heart transplantation (HTx). Traditionally, recipient age older than 65 years has been considered a contraindication for performing a HTx because these patients have more comorbidities, are more affected by the adverse effects of immunosuppressive drugs, and obtain a smaller benefit in the medium and long term. Therefore, given the shortage of donors, priority was given to younger recipients. In recent years, studies have been published demonstrating that HTx in this population segment is possible. These results indicate that despite suffering more infections and having longer hospital stays, these patients have fewer rejections, with an overall survival in the medium and long term similar to that of HTx in younger patients. These results have been achieved partly as a result of appropriate selection of recipients and emergence of new immunosuppressive agents that has allowed their use to be individualized to the characteristics and comorbidities of each patient. Despite the latest advances, longer-term multicenter studies are required to clarify the role of alternate lists and the impact of new ventricular assist devices in this population segment.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2011.05.013