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Younger patients more likely to live at least 10 years after heart transplant
Kilic A. Ann Thorac Surg. 2012;93:699-704.
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Heart transplant patients who receive new organs before the age of 55 years and those whose procedure was performed at a higher-volume medical center are significantly more likely to survive at least 10 years after their operation compared with older patients and procedures performed at lower-volume centers, new research suggests.
Using information from the United Network for Organ Sharing (UNOS), researchers compared mortality and predictors of mortality among 9,404 heart transplant recipients who survived 10 or more years compared with 10,373 patients who did not survive. All transplants occurred between 1987 and 1999.
Patients aged 55 years and younger at the time of transplant had a 24% greater chance of 10-year survival compared with older patients.
“After the age of 55, we see the biggest difference in long-term survival. The chance of surviving for 10 years drops precipitously,” Arman Kilic, MD, a surgical resident at The Johns Hopkins Hospital, said in a press release.
The age of the donor was also significant. For every decade younger the donor was, the heart transplant recipient was 10% more likely to survive 10 or more years.
Other results showed:
- Patients whose transplant occurred at hospitals performing nine or more transplants per year had a 31% greater chance for 10-year survival vs. patients who underwent procedures at hospitals performing fewer than nine transplants per year.
- White patients were 35% more likely to survive 10 years or more vs. non-white patients.
- Patients on mechanical ventilators before transplant were 47% more likely to die within 10 years of surgery vs. patients not on ventilation.
- Patients with diabetes were 33% more likely to die within 10 years of transplant vs. patients without diabetes.
- For every hour ischemic time was reduced, there was an 11% greater chance for 10-year survival.
It is estimated that there are 2,000 to 2,500 heart transplants in the United States every year.
“These data could be used for both prognosis and allocation purposes. They help predict which patients have the best chance to derive the longest and most sustainable benefit from the limited number of hearts that become available each year,” Kilic said in the release. “It also identifies areas that need further research, such as why racial disparities exist in long-term survival following heart transplant.”
Disclosure: Dr. Kilic and colleagues report no relevant financial disclosures.