October 20, 1998
UNOS Team Authors Journal Of Heart And Lung Transplantation Article
A scientific article titled, "Transplantation with Older Donor Hearts for Presumed "Stable" Recipients: An Analysis of the Joint International Society for Heart and Lung Transplantation/United Network for Organ Sharing Thoracic Registry," was published in the September 1998 Journal of Heart and Lung Transplantation. The article was authored by Leah Bennett, Ph.D., and Erick Edwards, Ph.D., of UNOS, and Jeffrey Hosenpud, M.D. of the Medical College of Wisconsin.
The article was based on a UNOS study performed to determine whether it was better to use a heart from an older donor in a relatively stable patient or to continue waiting for a younger heart, which may not come along in time.
The Joint ISHLT/UNOS Thoracic Registry Report and other reports have clearly demonstrated that increasing donor age is an important risk factor for death after transplant. A growing number of hearts are being recovered from donors 45 years and older, though, because of the severe organ shortage.
Based on an analysis of adult patients listed for their first heart transplant between 1992 and 1995 as a Status 2 (excluding patients on a ventilator), the study indicated that in spite of an initial high risk from the transplant procedure, there was a clear long-term benefit for Status 2 recipients of older donor hearts. Though there was an increased risk of mortality for these recipients when compared to recipient of younger donor hearts, the risk of death while continuing to wait (perhaps for a younger donor heart) was even greater.
The results do not imply that every potential donor over 50 years of age is a suitable heart donor. The older donor hearts recovered between 1992 and 1995 were likely to have been carefully screened because of their age. The study indicates that older donors should not be eliminated from the donor pool solely due to their age.
Noted UNOS Assistant Executive Director of Operations O. Patrick Daily, Ph.D., "This is a very important step as the transplant community wrestles with the expanded donor issue. We now know that older hearts can be used, and should be used, if carefully screened. This demonstrates yet another way the transplant community is working to increase the organ supply to save patients' lives."
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