UCLA Approach Expands Heart Donor Pool for Transplantation
NEW ORLEANS (Reuters Health) – Marginal hearts from older donors can be used for older patients, thereby expanding the limited pool of donor organs, UCLA transplant surgeons reported here at the annual meeting of the American Heart Association.
“There is a difference in survival goals between the younger and older patients,” noted Dr. Daniel Marelli, of the University of California at Los Angeles. “We can use these organs that we would not normally use in younger patients.”
At UCLA, patients younger than 65 are placed on the standard waiting list for organ donation. Those older than 70 are placed on an alternate list, to receive the marginal donor hearts. Those between the ages of 65 and 70 can choose which list they want to be on, and Dr. Marelli said that many of these patients choose the alternate list, so that younger patients can get the younger hearts.
Transplant results with marginal hearts in older patients have been good, with significant improvement in quality of life, Dr. Marelli reported. He and his colleagues reviewed the cases of 175 patients age 62 or older, 54 of whom were placed on the alternate list. For those on the standard list, who received optimal hearts, survival was 92% at 30 days and 72% at 5 years. For those who received marginal hearts, survival was 90% at 30 days and 78% at 4 years.
“Using a dual-listing strategy may allow for heart transplant in the elderly without limiting the supply of organs for others,” the UCLA team said in an AHA release.
