Does Donor-recipient Age Difference Matter in the Outcome of Heart Transplantation?

Purpose: With the growing shortage of organ donors, marginal donor organs are increasingly accepted, which may partially explain the continued increase in donor age. The potential interactions between donor-recipient (D/R) age difference and outcomes after heart transplantation (HT) are not well known, and organ allocation systems do not routinely consider D/R age matching. We thus aimed to study the impact of D/R age difference on HT outcomes.

Methods: Between 1995-2017 we assessed 234 HT patients. Based on D/R age difference histogram, we stratified these patients into 3 groups: older donors (D/R difference >0; n=48), younger donors (D/R difference 0 to -20 years; n=82), and much younger donors (D/R difference

Results: The baseline metabolic risk profile of the patients was significantly higher for the younger donor groups, including hypertension (52%/33%/25%, p=0.002), dyslipidemia (51%/51%/29%, p=0.027), diabetes (30%/16%/17%, p=0.044) and smoking history (53%/46%/29%, p=0.024), respectively. There were no significant differences between the groups in long-term survival, freedom from CAV or ATR in unadjusted and adjusted analyses (Table). In the much younger donor group (D/R difference

Conclusion: D/R age difference does not significantly impact long-term HT outcomes. However, among younger donors with a D/R age difference <-20, gender matching was associated with a lower incidence of PGD. Given the constant shortage of donor hearts, organs from older donors with a high D/R age difference can be successfully utilized.