Time-dependent prognostic effects of recipient and donor age in adult heart transplantation

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Time-dependent prognostic effects of recipient and donor age in adult heart transplantation

Bergenfeldt, Henrik (author): Lund University,Lunds universitet,Thoraxkirurgi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Artificiell intelligens och thoraxkirurgisk vetenskap (AICTS),Forskargrupper vid Lunds universitet,Thoracic Surgery,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Artificial Intelligence in CardioThoracic Sciences (AICTS),Lund University Research Groups,Helsingborg Hospital

Lund, Lars H. (author): Karolinska Institutet,Karolinska Institute,Karolinska University Hospital

Stehlik, Josef (author): University of Utah

Andersson, Bodil (author): Lund University,Lunds universitet,Kirurgi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Artificiell intelligens och thoraxkirurgisk vetenskap (AICTS),Forskargrupper vid Lunds universitet,Surgery (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Artificial Intelligence in CardioThoracic Sciences (AICTS),Lund University Research Groups,Skåne University Hospital

Höglund, Peter (author): Lund University,Lunds universitet,Avdelningen för klinisk kemi och farmakologi,Institutionen för laboratoriemedicin,Medicinska fakulteten,Artificiell intelligens och thoraxkirurgisk vetenskap (AICTS),Forskargrupper vid Lunds universitet,Division of Clinical Chemistry and Pharmacology,Department of Laboratory Medicine,Faculty of Medicine,Artificial Intelligence in CardioThoracic Sciences (AICTS),Lund University Research Groups,Skåne University Hospital

Nilsson, Johan (author): Lund University,Lunds universitet,Thoraxkirurgi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Hjärt- och lungtransplantation,Forskargrupper vid Lunds universitet,Artificiell intelligens och thoraxkirurgisk vetenskap (AICTS),Artificiell intelligens och bioinformatik inom thoraxkirurgisk vetenskap,Thoracic Surgery,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Heart and Lung transplantation,Lund University Research Groups,Artificial Intelligence in CardioThoracic Sciences (AICTS),Artificial Intelligence and Bioinformatics in Cardiothoracic Sciences (AIBCTS)

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Elsevier BV, 2019
2019
English.
In: Journal of Heart and Lung Transplantation. - : Elsevier BV. - 1053-2498. ; 38:2, s. 174-183

Related links:: http://dx.doi.org/10...; show more...; https://lup.lub.lu.s...; https://doi.org/10.1...; http://kipublication...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

BACKGROUND: Recipient age and donor age are well-known prognostic factors in adult heart transplantation. However, the association between donor age and recipient age and their interaction and short- and long-term mortality is unknown. METHODS: We studied 64,354 heart transplants to adult recipients between 1988 and 2013 in the ISHLT Registry. Donor age and recipient age were analyzed as continuous and categorical variables and restricted cubic spline functions to assess non-linear associations and interactions. The end-point was all-cause mortality. RESULTS: In the multivariable analysis, the odds ratio for 30-day mortality per 10-year increase in recipient age was 1.05 (95% confidence interval [CI] 1.01 to 1.08, p = 0.009) compared with 1.19 (95% CI 1.15 to 1.22, p < 0.001) for donor age. In the first year, the hazard ratio for mortality was 1.05 (95% CI 1.02 to 1.07, p < 0.001) for a 10-year increase in recipient age and 1.16 (1.14 to 1.18, p < 0.001) for donor age. In Years 1 to 3, 3 to 5, and 5 to 10 post-transplant, the hazard ratio was 0.89 (95% CI 0.86 to 0.92, p < 0.001), 0.98 (95% CI 0.94 to 1.02, p = 0.266), and 1.14 (95% CI 1.11 to 1.17, p < 0.001) for recipient age, and 1.12 (95% CI 1.08 to 1.14, p < 0.001), 1.07 (95% CI 1.03 to 1.10, p < 0.001), and 1.07 (95% CI 1.05 to 1.10, p < 0.001) for donor age, respectively. There was no interaction of recipient age and donor age with survival at any follow-up time-point. CONCLUSIONS: At 30 days, both higher donor age and recipient age were associated with higher mortality. At 1 to 10 years, older donor age was associated with higher mortality at all follow-up time-points, but the hazard was greater in the short term, and recipient age was associated only with longer term mortality. The risk from donor age appears equal across recipient age groups.

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By the author/editor: Bergenfeldt, Hen ...; Lund, Lars H.; Stehlik, Josef; Andersson, Bodil; Höglund, Peter; Nilsson, Johan

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

Articles in the publication: Journal of Heart ...; The Journal of h ...

By the university: Lund University; Karolinska Institutet

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Time-dependent prognostic effects of recipient and donor age in adult heart transplantation

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