Outcomes in Patients Older Than 60 Years of Age Undergoing Orthotopic Heart Transplantation: An Analysis of the UNOS Database

Weiss, Eric S.; Nwakanma, Lois U.; Patel, Nishant; Yuh, David D.

doi:10.1016/j.healun.2007.11.566

Cited by 84 publications

(56 citation statements)

References 16 publications

(17 reference statements)

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“…Во многих трансплантационных центрах ТС от возрастных доноров выполняется реципиентам старших возрастных групп по принципу «возраст ной донор -возрастной реципиент» [64]. Для воз растных реципиентов характерна высокая степень коморбидности, частое наличие предсуществую щей почечной дисфукции, СД, артериальной гипер тензии, цереброваскулярной патологии, мультифо кального атеросклероза, низкого инфекционного порога, что само по себе является фактором, нега тивно влияющим на раннюю и отдаленную выжи ваемость [65,66].…”

Section: возрастной донор и выживаемость после тсunclassified

Heart transplantation from older donors

Попцов

Спирина

Колоскова

et al. 2017

RJTAO

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ФГБУ «Федеральный научный центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава России, Москва, Российская Федерация В сложившейся ситуации дефицита донорских органов выполнение трансплантации сердца от так назы ваемых возрастных доноров является одним из реальных путей повышения доступности и увеличения количества пересадок сердца, прежде всего у потенциальных реципиентов, нуждающихся в неотложном ее выполнении. При подготовке и выполнении трансплантации сердца от возрастных доноров необходи мо учитывать повышенный риск развития ранней дисфункции сердечного трансплантата, наличия транс миссивного атеросклероза коронарных артерий, развития и прогрессирования васкулопатии сердечного трансплантата, что может негативно сказаться на ранней и отдаленной выживаемости реципиентов. При правильном подборе пары «донор-реципиент», эффективном разрешении ранней дисфункции сердеч ного трансплантата, своевременном применении лечебных мер, направленных на профилактику васку лопатии сердечного трансплантата, а также на коррекцию трансмиссивного атеросклероза коронарных артерий, ранние и отдаленные результаты трансплантации сердца от возрастных доноров сопоставимы с результатами трансплантации от доноров со стандартными критериями. Ключевые слова: сердечная недостаточность, трансплантация сердца.hearT TranSPlanTaTiOn frOM OlDer DOnOrS In the current situation of the shortage of suitable donor organs, heart transplantation from older donors is one of the ways to increase the performance of more heart transplants, particularly, in patients with urgent need of transplantation. While planning a heart transplantation from older donor one should consider increased risk of early cardiac allograft dysfunction, preexisting coronary artery disease, accelerated transplant vasculopathy which may adversely affect early and longterm survival of recipients. Subject to careful selection of donor-reci pient pairs, effective prevention and treatment of early cardiac allograft dysfunction, preexisting atherosclerosis and transplant vasculopathy the early and longterm survival of heart transplant recipients from older donors is comparable to heart transplantation from young donors.

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Section: возрастной донор и выживаемость после тсunclassified

Heart transplantation from older donors

Попцов

Спирина

Колоскова

et al. 2017

RJTAO

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“…These age groups have been used in prior analyses, and mirror the changes in ISHLT recommendations over time. 2,3,[5][6][7][8][9] We calculated the frequency of heart transplants by age group for each year. Baseline characteristics of transplant recipients were described using means and standard deviations or medians and interquartile ranges for continuous variables and frequencies and percentages for categorical variables.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…Outcomes were adjusted for select baseline characteristics of transplant recipient and donor, chosen a priori based on prior studies and clinical relevance. [8][9][10]13,14 Single imputation was used for missing values. Missing values for continuous variables were imputed to the median, and missing values for categorical variables were imputed to the most frequent category.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…3 In the United States, transplantation of older adults is increasingly performed, but limited contemporary data exist regarding outcomes for elderly patients. [4][5][6][7][8] To evaluate transplantation in older adults, we used data from the United Network for Organ Sharing (UNOS) to analyze the demographics and outcomes of patients ≥70 years of age compared with patients 60-69 years of age and 18-59 years of age at the time of cardiac transplant.…”

Section: Introductionmentioning

confidence: 99%

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Cardiac Transplantation for Older Patients: Characteristics and Outcomes in the Septuagenarian Population

Cooper

Mentz

et al. 2015

Journal of Cardiac Failure

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“…Due to demographic changes the number of elderly persons undergoing solid organ transplantation has increased substantially in the last years [1,2,3,4]. In the past, advanced age was a contraindication, for example, to kidney transplantation.…”

Section: Introductionmentioning

confidence: 99%

Effect of Different Immunosuppressive Drugs on Immune Cells from Young and Old Healthy Persons

Welzl

Kern

Mayer³

et al. 2014

Gerontology

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Background: Life expectancy, as well as the average age of patients undergoing solid organ transplantation, increases constantly. Consequently, immunosuppressive therapy is no longer limited to young organ recipients. Objective: Here, we investigate how different types of immunosuppressive therapy, namely the calcineurin inhibitors cyclosporin A and tacrolimus, as well as the mTOR inhibitor rapamycin, affect the function of immune cells in young and elderly persons. Methods: Proliferation, cell viability, cytokine production (IL-2, IFN-γ), H₂O₂ production and telomere length of phytohemagglutinin (PHA)-stimulated human peripheral blood mononuclear cells (PBMCs) of young (n = 13; median age 27 years) and old (n = 19; median age 71 years) healthy donors were analyzed. Results: The inhibition of proliferation was dampened in PBMCs from elderly donors, especially after incubation with rapamycin. All three immunosuppressive drugs inhibited the production of IL-2 equally well, whereas the production of IFN-γ was less well inhibited by rapamycin. Both calcineurin inhibitors increased H₂O₂ concentrations after stimulation with PHA and led to a shortening of telomeres in PBMCs from young and old individuals. Rapamycin had only minor effects on H₂O₂ production and telomere length. Conclusion: Our results demonstrate that the effects of immunosuppressive drugs on PBMCs differ between young and elderly persons. Calcineurin inhibitors compared to rapamycin have a more pronounced prosenescence effect. These data indicate that specific treatment regimens for the elderly might therefore be considered.

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Outcomes in Patients Older Than 60 Years of Age Undergoing Orthotopic Heart Transplantation: An Analysis of the UNOS Database

Cited by 84 publications

References 16 publications

Heart transplantation from older donors

Heart transplantation from older donors

Cardiac Transplantation for Older Patients: Characteristics and Outcomes in the Septuagenarian Population

Effect of Different Immunosuppressive Drugs on Immune Cells from Young and Old Healthy Persons

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