LONG-TERM RESULTS OF CARDIAC TRANSPLANTATION IN PATIENTS OLDER THAN 60 YEARS

Advanced age has traditionally been a contraindication to cardiac tran splantation. We have, however, offered cardiac transplantation to pati ents older than 60 years with end-stage heart failure if they were oth erwise acceptable candidates, From 1985 to 1994, 527 patients underwen t cardiac transplantation. Among these patients, 101 were older than 6 0 years at transplantation. The mean follow-up of this group is 6 year s, Patients older than 60 years had significantly fewer rejection epis odes per patient than those who were younger than 60 years at transpla ntation (1.9 +/- 1.3 vs 2.6 +/- 1.8, p = 0.009). No difference in the number of infectious complications per patient was detected between th e two groups. Both short-term and longterm survival after transplantat ion were significantly lower for patients who were older than 60 Sears at transplantation than for younger patients Cp < 0.05). The 6-year a ctuarial survival after transplantation for patients older than 60 yea rs was 54% compared with 72% for patients younger than 60 years at tra nsplantation (p < 0.05). Patients older than 60 years at transplantati on were more likely to die of infectious complications or malignant di sease after transplantation (p < 0.05), We believe caution is warrante d in offering cardiac transplantation to patients older than 60 years, This group of patients should be carefully observed for the developme nt of potentially life-threatening infectious complications or new mal ignant tumors after transplantation.