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首页> 外文期刊>Journal of cardiac surgery. >Effect of donor age on long-term survival following cardiac transplantation.
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Effect of donor age on long-term survival following cardiac transplantation.

机译：供体年龄对心脏移植后长期生存的影响。

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Background and Aim: The current shortage of donor hearts has forced the criteria of organ procurement to be extended, leading to increased use of older donor hearts to bridge the gap between demand and availability. Our objective was to analyze the effect of donor age on outcomes after cardiac transplantation. Methods: We retrospectively studied 864 patients who underwent cardiac transplantation at New York Presbyterian Hospital - Columbia University between 1992 and 2002. Patients were divided into two groups; donor age <40 years (Group A, n = 600) and donor age >/=40 years (Group B, n = 264). Results: Characteristics including gender, body mass index, and cytomegalovirus (CMV) status were significantly different between the two donor age groups. Race, CMV status, toxoplasmosis status, left ventricular assist device prior to transplant, diabetes mellitus, and retransplantation were similar in both the recipient groups, while age, gender, and BMI were different. Early mortality was lower in Group A, 5%, versus 9.5% in Group B. Multivariate analysis revealed recipient female gender (odd ratio (OR) = 1.71), retransplantation (OR = 1.63), and increased donor age (OR = 1.02) as significant predictors of poor survival in the recipient population. Actuarial survival at 1 year (86.7% vs 81%), 5 years (75% vs 65%), and 10 years (56% vs 42%) was significantly different as well with a log rank p = 0.002. Conclusions: These findings suggest that increased donor age is an independent predictor of long-term survival. However, the shortage of organs makes it difficult to follow strict guidelines when placing hearts; therefore, decisions need to be made on a relative basis.
机译：背景与目的：目前供体心脏的短缺迫使器官采购标准得到扩展，导致更多使用较老的供体心脏来弥合需求与供应之间的差距。我们的目的是分析供体年龄对心脏移植后预后的影响。方法：我们回顾性研究了1992年至2002年间在哥伦比亚大学纽约长老会医院接受心脏移植的864例患者。供体年龄<40岁（A组，n = 600）和供体年龄> / = 40年（B组，n = 264）。结果：两个供体年龄组之间的性别，体重指数和巨细胞病毒（CMV）状态等特征存在显着差异。两组患者的种族，CMV状态，弓形虫状态，移植前左心室辅助装置，糖尿病和再移植均相似，而年龄，性别和BMI则不同。 A组的早期死亡率较低，为5％，而B组为9.5％。多变量分析显示，接受者的女性为性别（比值（OR）= 1.71），再移植（OR = 1.63）和供体年龄增加（OR = 1.02）。作为接受人群中不良生存的重要预测指标。 1年的精算生存率（86.7％对81％），5年（75％对65％）和10年（56％对42％）也有显着差异，对数等级p = 0.002。结论：这些发现表明供体年龄的增加是长期存活的独立预测因素。但是，由于器官不足，放置心脏时很难遵循严格的指导原则。因此，需要相对地做出决定。

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