Age is an important consideration among patients being considered for heart transplantation (HT) due to concerns for reduced survival in the context of limited donor availability. However, as the aging population grows, there are a greater number of older patients with heart failure being evaluated for heart replacement therapy, including heart transplantation or left ventricular assist device (LVAD). In accordance, new strategies and policies to address age as a heart transplantation criterion are needed.

A 73-year-old woman presents to your office with stage D NYHA class IV non-ischemic cardiomyopathy on maximum tolerated goal-directed medical therapy, with further dose escalation limited by hypotension. The following question addresses the role of age as a criterion for heart transplantation, based on the most recent International Society of Heart and Lung Transplantation (ISHLT) guidelines.

Clinical Topics: Cardiac Surgery, Cardiovascular Care Team, Geriatric Cardiology, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Cardiac Surgery and Heart Failure, Acute Heart Failure, Heart Transplant, Mechanical Circulatory Support

Keywords: Aged, Heart-Assist Devices, Goals, Heart Transplantation, Heart Failure, Aging, Tissue Donors, Lung Transplantation, Hypotension, Contraindications, Policy, Cardiomyopathies, Geriatrics

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