Seniors’ Health: New hearts work well in the over-70 crowd

In most cases, survival rates after transplant are just as good as in younger people

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It used to be unheard of for people in their 70s to undergo a heart transplant, but it turns out older people do reasonably well after the procedure.

“The cutoff point for heart transplantation used to be age 65 and, as we have become more comfortable with the process of heart transplantation, we are now offering heart transplantation to patients over the age of 70 and we have gone up to age 78,” says Dr. Jignesh Patel, associate medical director of the heart transplant program for the University of California at Los Angeles.

Patel and his colleagues found that septuagenarians gain just as much survival benefit as younger transplant recipients, provided they don’t have a hepatitis C infection or receive a heart from a donor who had the liver disease.

The researchers compared outcomes in 25 patients older than 70 years and 246 younger patients. After five years, 80 per cent of the younger patients were still alive, compared with 64 per cent of the older group. But the five-year survival rates were the same after the researchers excluded patients and organs infected with hepatitis C. “Patients over the age of 70 actually do quite well,” Patel says. “I am hoping these data provide some guidance in terms of the feasibility of heart transplantation in the older age group. So long as the older transplant population is adequately screened, they should do as well as the younger group.”

He adds that because older people have weaker immune systems, they don’t require as much anti-rejection medication and are less likely to reject their new organ.

Patel says this is one of the first studies to look at older heart transplant recipients and while these findings are encouraging, more research is needed with larger numbers of patients. “This is going to be a bigger and bigger issue in the future. If you look at the demographics, you can see that the numbers of patients in their 50s, 60s and 70s who are undergoing heart transplants are going up.”