Heart Transplant in Older Adults

Rushakoff, Joshua A.; Kransdorf, E.

doi:10.1007/s40472-022-00358-1

Cited by 5 publications

(3 citation statements)

References 54 publications

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“…In the past years, the rate of HT in older adults have increased, and there is a raising body of literature showing this is safe and feasible in carefully selected older adults. Older adult recipients seem to have similar survival, rehospitalization, and graft failure rates when compared to younger patients despite additional comorbidities and higher risk donors 6 . Our goal was to assess the impact of patient age under the new allocation policy on mortality following heart transplantation.…”

Section: Introductionmentioning

confidence: 99%

“…Older adult recipients seem to have similar survival, rehospitalization, and graft failure rates when compared to younger patients despite additional comorbidities and higher risk donors. 6 Our goal was to assess the impact of patient age under the new allocation policy on mortality following heart transplantation. Secondary outcomes included the effect of age ≥70 on post-transplant events, including stroke, dialysis, pacemaker, and rejection requiring treatment.…”

mentioning

confidence: 99%

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Impact of age over 70 years in the new allocation system on the outcomes of heart transplantation in the US

Gemelli,

Doulamis,

Addonizio

et al. 2024

Clinical Transplantation

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BackgroundUnited Network for Organ Sharing (UNOS) allocation criteria changed in 2018 to accommodate the increased prevalence of patients on a ventricular assist device as a bridge to heart transplant and prioritize sicker people in anticipation of a heart graft. We aimed to assess the impact of patient age in the new allocation policy on mortality following heart transplantation. Secondary outcomes included the effect of age ≥70 on post‐transplant events, including stroke, dialysis, pacemaker, and rejection requiring treatment.MethodsThe UNOS Registry was queried to identify patients who underwent heart transplants alone in the US between 2000 and 2021. Patients were divided into groups according to their age (over 70 and under 70 years old).ResultsPatients aged over 70 were more likely to require dialysis during follow‐up, but less likely to experience rejection requiring treatment, compared with patients aged <70. Age ≥70 in the new allocation system was a significant predictor of 1‐year mortality (adjusted HR: 1.41; 95% CI: 1.05–1.91; p = .024), but its effect on 5‐year mortality was not significant after adjusting for potential confounders (adjusted HR: 1.27; 95% CI:.97–1.66; p = .077). Undergoing transplantation under the new allocation policy vs the old allocation policy was not a significant predictor of mortality in patients over 70 years old.ConclusionsAge ≥70 is a significant predictor of 1‐year mortality following heart transplantation, but not at 5 and 10 years; however, the new allocation does not seem to have changed the outcomes for this group of patients.

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Impact of age over 70 years in the new allocation system on the outcomes of heart transplantation in the US

Gemelli,

Doulamis,

Addonizio

et al. 2024

Clinical Transplantation

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“…The proportion of patients undergoing different types of elective cardiac surgery and heart transplantation has increased over time, especially in the older population. 1 Despite accounting for less than 15% of in-patient procedures, high-risk patients account for 80% of deaths. 2 Improved postoperative outcome remains an important determinant of functional recovery, long-term survival, and healthcare costs.…”

Section: Introductionmentioning

confidence: 99%

Implementation of an epicardial implantable MEMS sensor for continuous and real-time postoperative assessment of left ventricular activity in adult minipigs over a short- and long-term period

Zinno,

Agnesi,

D'Alesio

et al. 2024

APL Bioengineering

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The sensing of left ventricular (LV) activity is fundamental in the diagnosis and monitoring of cardiovascular health in high-risk patients after cardiac surgery to achieve better short- and long-term outcome. Conventional approaches rely on noninvasive measurements even if, in the latest years, invasive microelectromechanical systems (MEMS) sensors have emerged as a valuable approach for precise and continuous monitoring of cardiac activity. The main challenges in designing cardiac MEMS sensors are represented by miniaturization, biocompatibility, and long-term stability. Here, we present a MEMS piezoresistive cardiac sensor capable of continuous monitoring of LV activity over time following epicardial implantation with a pericardial patch graft in adult minipigs. In acute and chronic scenarios, the sensor was able to compute heart rate with a root mean square error lower than 2 BPM. Early after up to 1 month of implantation, the device was able to record the heart activity during the most important phases of the cardiac cycle (systole and diastole peaks). The sensor signal waveform, in addition, closely reflected the typical waveforms of pressure signal obtained via intraventricular catheters, offering a safer alternative to heart catheterization. Furthermore, histological analysis of the LV implantation site following sensor retrieval revealed no evidence of myocardial fibrosis. Our results suggest that the epicardial LV implantation of an MEMS sensor is a suitable and reliable approach for direct continuous monitoring of cardiac activity. This work envisions the use of this sensor as a cardiac sensing device in closed-loop applications for patients undergoing heart surgery.

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Changes in heart transplant outcomes of elderly patients in the new allocation era

Sollie,

Kwon,

Usry

et al. 2024

The Journal of Thoracic and Cardiovascular Surgery

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Heart Transplant in Older Adults

Cited by 5 publications

References 54 publications

Impact of age over 70 years in the new allocation system on the outcomes of heart transplantation in the US

Impact of age over 70 years in the new allocation system on the outcomes of heart transplantation in the US

Implementation of an epicardial implantable MEMS sensor for continuous and real-time postoperative assessment of left ventricular activity in adult minipigs over a short- and long-term period

Changes in heart transplant outcomes of elderly patients in the new allocation era

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