Abstract：
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).
CONCLUSIONS: Overall, HT outcomes are excellent for carefully selected patients ≥70 years, and transplanting patients in this age cohort can be considered.
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).
CONCLUSIONS: Overall, HT outcomes are excellent for carefully selected patients ≥70 years, and transplanting patients in this age cohort can be considered.
摘要：
背景：高龄患者通常被认为是心脏移植（HT）的不良候选人。随着美国人口的老龄化,对于临床医生来说,了解如何最好地选择患者进行高级治疗非常重要.
方法：这是对2006年至2022年8月美国移植接受者科学注册数据的回顾性分析。如果是多器官移植的患者被排除在外，重新移植，或移植后不到1年。
结果：70岁以上的患者一年生存率为87.5%，<60岁时为91.1%，60-69岁时为88.4%(p<0.001)。存活率在数值上提高了，但并不重要，随着移植时代的进展，那些≥70年。通过Kaplan-Meier分析，在<60年的5年生存率最高（80.6%），60-69岁（78.2%）和≥70岁（77.1%）。当用相同的度量比较60-69年与70年以上时，差异有统计学意义(p=0.12)。70岁以上人群的一年生存率从2000-2009年（80.7%）提高到2018年10月以来的88.5%（p<0.001）。随着接受者年龄的增长，他们更有可能是男性，并且不太可能是黑人或西班牙裔/拉丁裔（p<0.001）。
结论：总体而言，对于精心选择的≥70岁的患者，HT结果非常好。和移植患者在这个年龄段可以考虑。
方法：这是对2006年至2022年8月美国移植接受者科学注册数据的回顾性分析。如果是多器官移植的患者被排除在外，重新移植，或移植后不到1年。
结果：70岁以上的患者一年生存率为87.5%，<60岁时为91.1%，60-69岁时为88.4%(p<0.001)。存活率在数值上提高了，但并不重要，随着移植时代的进展，那些≥70年。通过Kaplan-Meier分析，在<60年的5年生存率最高（80.6%），60-69岁（78.2%）和≥70岁（77.1%）。当用相同的度量比较60-69年与70年以上时，差异有统计学意义(p=0.12)。70岁以上人群的一年生存率从2000-2009年（80.7%）提高到2018年10月以来的88.5%（p<0.001）。随着接受者年龄的增长，他们更有可能是男性，并且不太可能是黑人或西班牙裔/拉丁裔（p<0.001）。
结论：总体而言，对于精心选择的≥70岁的患者，HT结果非常好。和移植患者在这个年龄段可以考虑。
