The influence of donor age on transplant coronary artery disease and survival post heart transplantation: is it safe to extend donor age?

Abstract Background Due to the increasing demand for suitable cardiac donor organs, acceptance criteria need to be re-evaluated. We retrospectively analyzed the effect of donor age on survival following cardiac transplantation. Method Three hundred thirty-five cardiac transplant recipients and corresponding donor data were reviewed using SPSS. Results Seventy-two recipients had early posttransplant angiography or postmortem data available. The mean donor age of recipients with evidence of graft coronary artery disease (32.5 ± 11.7 years) was significantly higher than that of recipients free of transplant coronary artery disease (TCAD) (24.8 ± 9.4 years; P = .003). Recipient of organs from donors aged less than 50 years were less likely to develop TCAD than those of donors aged over 50 years (odds ratio 0.333; 95% CI 0.239–0.465; P = .044). TCAD also occurred much earlier posttransplantation in recipients of organ from donors over 50 years (mean time 6.5 years; median 5.0 years) than those of donors under 50 years (mean time 12.7 years; median 14.0 years). Conclusion We observed no increase in mortality associated with cardiac donors over 50 years. However, increased donor age was associated with an increased incidence of TCAD.