Case Report: Cardiac transplantation in a 76-year-old recipient: moving from anagraphic to biological age under a geriatric perspective

Background/objectivesHeart 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 e...

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Main Authors: Lorenzo Giovannico, Federica Mazzone, Giuseppe Fischetti, Domenico Parigino, Luca Savino, Claudia Leo, Giuseppe Cristiano, Tommaso Acquaviva, Nicola Di Bari, Massimo Padalino, Tomaso Bottio
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Transplantation
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Online Access:https://www.frontiersin.org/articles/10.3389/frtra.2025.1595938/full
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author Lorenzo Giovannico
Federica Mazzone
Giuseppe Fischetti
Domenico Parigino
Luca Savino
Claudia Leo
Giuseppe Cristiano
Tommaso Acquaviva
Nicola Di Bari
Massimo Padalino
Tomaso Bottio
author_facet Lorenzo Giovannico
Federica Mazzone
Giuseppe Fischetti
Domenico Parigino
Luca Savino
Claudia Leo
Giuseppe Cristiano
Tommaso Acquaviva
Nicola Di Bari
Massimo Padalino
Tomaso Bottio
author_sort Lorenzo Giovannico
collection DOAJ
description Background/objectivesHeart 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.MethodsA 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.ResultsThe 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.ConclusionsThis 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.
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spelling doaj-art-80f7fd87012f4757b35a689db747e03d2025-08-20T03:15:20ZengFrontiers Media S.A.Frontiers in Transplantation2813-24402025-07-01410.3389/frtra.2025.15959381595938Case Report: Cardiac transplantation in a 76-year-old recipient: moving from anagraphic to biological age under a geriatric perspectiveLorenzo GiovannicoFederica MazzoneGiuseppe FischettiDomenico PariginoLuca SavinoClaudia LeoGiuseppe CristianoTommaso AcquavivaNicola Di BariMassimo PadalinoTomaso BottioBackground/objectivesHeart 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.MethodsA 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.ResultsThe 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.ConclusionsThis 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.https://www.frontiersin.org/articles/10.3389/frtra.2025.1595938/fullheart transplantationelderly patientsdonor criteriaheart failure treatmenttransplant eligibility
spellingShingle Lorenzo Giovannico
Federica Mazzone
Giuseppe Fischetti
Domenico Parigino
Luca Savino
Claudia Leo
Giuseppe Cristiano
Tommaso Acquaviva
Nicola Di Bari
Massimo Padalino
Tomaso Bottio
Case Report: Cardiac transplantation in a 76-year-old recipient: moving from anagraphic to biological age under a geriatric perspective
Frontiers in Transplantation
heart transplantation
elderly patients
donor criteria
heart failure treatment
transplant eligibility
title Case Report: Cardiac transplantation in a 76-year-old recipient: moving from anagraphic to biological age under a geriatric perspective
title_full Case Report: Cardiac transplantation in a 76-year-old recipient: moving from anagraphic to biological age under a geriatric perspective
title_fullStr Case Report: Cardiac transplantation in a 76-year-old recipient: moving from anagraphic to biological age under a geriatric perspective
title_full_unstemmed Case Report: Cardiac transplantation in a 76-year-old recipient: moving from anagraphic to biological age under a geriatric perspective
title_short Case Report: Cardiac transplantation in a 76-year-old recipient: moving from anagraphic to biological age under a geriatric perspective
title_sort case report cardiac transplantation in a 76 year old recipient moving from anagraphic to biological age under a geriatric perspective
topic heart transplantation
elderly patients
donor criteria
heart failure treatment
transplant eligibility
url https://www.frontiersin.org/articles/10.3389/frtra.2025.1595938/full
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