More Older Patients Are Getting New Hearts, Lungs


PHILADELPHIA — Heart and lung transplants are increasingly for older patients, on the basis of data collected in the International Heart and Lung Transplant Registry.

During 1999–2003, the most recent period with available registry data, patients aged at least 60 years made up about 25% of all patients who underwent heart transplants, up from about 15% a decade earlier, Marshall I. Hertz, M.D., reported at the annual meeting of the International Society for Heart and Lung Transplantation.

The rise in transplants in elderly patients was matched by an almost identical drop in patients aged 40–49 years, from about 23% of the total in 1989–1993 to about 15% in 1999–2003. The percentage of transplants done in patients aged 50–59, held steady at about 33% of the total, reported Dr. Hertz, professor of medicine at the University of Minnesota, Minneapolis, and medical director of the transplant registry.

A similar trend existed for lung transplantations. During 1997–2004, about 15% of all lung transplants were in patients aged 60–64, up from about 8% of the total in 1985–1996. Another clear increase was in patients aged 65 and older, rising from about 2% of all lung transplants in 1985–1996 to about 4% in the most recent period. In contrast, the percentage of transplants fell in all adult patients younger than 55. The biggest drop was in patients aged 45–49, where the figure sank from about 15% of all transplants in the earlier years to about 10% of all lung transplants in 1997–2003.

These trends reflect the “greater comfort” physicians have in transplanting older patients, Dr. Hertz told this newspaper. The rise in heart transplants in older patients has also been triggered by an increased prevalence of heart failure. But the registry data also confirm that survival following transplantation of either a heart or a lung is worse in older patients, Dr. Hertz said.

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