BACKGROUND Patients of advanced age are often considered to be poor candidates for heart transplant (HT). As the U.S. population continues to age, it is important for clinicians to understand how best to select patients for advanced therapies. METHODS This was a retrospective analysis of the U.S. Scientific Registry of Transplant Recipients data from 2006 to August 2022 in adult recipients. Patients were excluded if they were multiorgan transplant, re-do transplants, or less than 1 year post transplant. RESULTS Recipients ≥70 had a 1-year survival of 87.5%, compared to 91.1% for <60%, and 88.4% for 60-69 years (p < 0.001). Survival improved numerically, but not significantly, as transplant eras progressed for those ≥70 years. Survival by Kaplan-Meier analysis was greatest at 5 years for <60 years (80.6%), compared to 60-69 years (78.2%) and ≥70 years (77.1%). When comparing 60-69 years to ≥70 years by this same metric, there was significant difference (p = 0.12). One year survival for those ≥70 years has improved from 2000-2009 (80.7%) to 88.5% since October 2018 (p < 0.001). As recipients increased in age, they were more likely to be male, and less likely to be Black or Hispanic/Latino (p < 0.001). CONCLUSION Overall, HT outcomes are excellent for carefully selected patients ≥70 years, and transplanting patients in this age cohort can be considered.

中文翻译：

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美国 70 岁以上患者心脏移植结果的趋势：移植受者数据库科学登记分析。


背景 高龄患者通常被认为不适合心脏移植 （HT）。随着美国人口的持续老龄化，临床医生了解如何最好地选择接受先进治疗的患者非常重要。方法 这是对 2006 年至 2022 年 8 月美国移植受者科学登记处成年受者数据的回顾性分析。如果患者是多器官移植、重做移植或移植后不到 1 年，则被排除在外。结果 受者 ≥70 的 1 年生存率为 87.5%，而 <60 为 91.1%，60-69 岁为 88.4% （p < 0.001）。随着移植年龄的进展，存活率在数值上有所提高，但≥ 70 年没有显着提高。与 60-69 岁 （78.2%） 和 ≥70 岁 （77.1%） 相比，Kaplan-Meier 分析在 <60 年 （80.6%） 的 5 年生存率最高。当通过相同的指标将 60-69 岁与 ≥70 岁进行比较时，存在显着差异 （p = 0.12）。自 2018 年 10 月以来，70 ≥ 岁的一年生存率从 2000-2009 年 （80.7%） 提高到 88.5% （p < 0.001）。随着接受者年龄的增长，他们更可能是男性，而不太可能是黑人或西班牙裔/拉丁裔 （p < 0.001）。结论 总体而言，精心挑选的 70 岁≥患者的 HT 结局非常好，可以考虑该年龄组的移植患者。