CASE REPORT article
Front. Transplant.
Sec. Thoracic Transplantation
Volume 4 - 2025 | doi: 10.3389/frtra.2025.1595938
Cardiac Transplantation in a 76-Year-Old Recipient: Moving from Anagraphic to Biological Age under a Geriatric Perspective
Provisionally accepted
Lorenzo Giovannico*
Federica Mazzone
Giuseppe Fischetti
Domenico PariginoLuca SavinoClaudia LeoGiuseppr CristianoTommaso AcquavivaNicola Di BariMassimo PadalinoTomaso Bottio- Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Bari, Italy
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Background/Objectives: Heart transplantation remains the definitive treatment for end-stage heart failure. However, donor shortages and the increasing age of candidates present significant challenges. This report aims to highlight the feasibility and successful outcome of heart transplantation in an elderly patient, questioning traditional age-based eligibility criteria. Methods: A 76-year-old male with idiopathic dilated cardiomyopathy and severe heart failure underwent orthotopic heart transplantation. Preoperative assessments included right heart catheterization, echocardiography, and cardiac index evaluation. A suitable 66-year-old female donor was identified, and transplantation was performed using the bicaval technique. Postoperative outcomes were monitored through echocardiography and biopsy analysis. Results: The patient had an uneventful postoperative course, with extubation on day 1 and discharge on postoperative day 30. Follow-up at 14 months showed excellent clinical recovery, with an improved left ventricular ejection fraction (LVEF) of 58% and global longitudinal strain (GLS) of -20.8%. No signs of rejection were observed on biopsy. Conclusions: This case represents the oldest documented successful heart transplant recipient discharged home. The findings suggest that age alone should not be a limiting factor in transplantation eligibility. Expanding criteria to include well-selected elderly patients could help address the growing demand for donor hearts.
Keywords: Heart Transplantation, elderly patients, Donor criteria, Heart failure treatment, transplant eligibility
Received: 18 Mar 2025; Accepted: 12 Jun 2025.
Copyright: © 2025 Giovannico, Mazzone, Fischetti, Parigino, Savino, Leo, Cristiano, Acquaviva, Di Bari, Padalino and Bottio. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lorenzo Giovannico, Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Bari, Italy
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