Impact of Donor and Recipient Age on 5-year Survival Following Heart Transplantation: A 24-year National Analysis from the United Kingdom

Purpose The impact of donor and recipient age on outcomes following heart transplantation remains controversial. The aim of this study was to evaluate the impact of donor and recipient age on 5-year survival following heart transplantation in the UK Methods Data were extracted from the UK Transplant Registry held by NHS Blood and Transplant on 3192 adult (≥18) DBD heart transplants in the UK between 1995 and 2018 inclusive. Donors and recipients were divided into 3 age groups (18-40, 41-50, 51+ years) for analysis. Kaplan-Meier survival curves and Cox-proportional hazards models (adjusted for donor cause of death, donor BMI, recipient BMI, creatinine, VAD status, primary disease, sex mismatch, ischemia time, and OCS use) were used to estimate the effect of recipient and donor age on 5-year patient survival and survival conditional on 90-days Results The overall median recipient and donor age was 50 years and 38 years, respectively, with donor age increasing over time Un-adjusted analysis showed a significant difference in 5-year survival for both donor and recipient age groups, p Conclusion We have demonstrated that donor age is a statistically significant variable in modelling post heart transplant survival at 5 years. However, once a patient has survived the first three months post-transplant, donor age no longer significantly impacts on longer-term outcomes