How effective are heart valve transplants from organ donors of years of age K. Grosse 1, R. Meyer 2, C. Wesslau 3, D. Bösebeck 1, R. Hetzer 2, G. Kirste 1 1 Deutsche Stiftung Organtransplantation, Germany 2 Deutsches Herzzentrum Berlin, Germany 3 Stiftung Europäischer Gewebebanken Berlin, Germany Deutsches Herzzentrum Berlin

Organ Donors over 65 Years of Age in Germany % year

Above the Age Limit of 65 Years ( Test Group, n=100) Below the Age Limit of 65 Years ( Control Group, n=380) Valves, total [n] Valve Grafts [n]100 (50%)379 (50%) Aortic Valve Grafts [n] 15 (15%)113 (30%) Pulmonary Valve Grafts [n] 85 (85%)266 (70%) Heart Valve Donors ( )

[Years] former Age Limit Aortic Valve Allografts Pulmonary Valve Allografts Morphologically Optimal (code 1-2) Acceptable (code 3-5) Unsuitable (code 6) for Transplantation* 4 th Decade of Life [%] Heart Valve Donors ( ) *Quality Codes of the Bio Implant Services (BIS)

Organ Donors Heart Donors Heart Valve Donors Pulmonary Valve Grafts Aortic Valve Grafts Donors/Valves [n] Distribution Of Gender [n] ♀ 42 ♂ 57 ♀ 4 ♂ 4 ♀ 21 ♂ 28 ♀ 11 ♂ 10 ♀ Mean Age at Donation [Years] ♀+♂ 67 ♀ 68 ♂ 65,5 ♀+♂ 67 ♀ 66,5 ♂ Heart Valve Grafts from Elderly Organ Donors* ( ) *from 65 to 70 years of age

Total Recipients Transplanted Recipients Successful** Heart Valve Replacement Recipients [n] (74%) Distribution Of Gender [n] ♀ 7 ♂ 15 ♀ 6 ♂ 13 ♀ 6 ♂ 8 Mean Age at Transplantation [Years] ♀ 25 ♂ 36 ♀ 25 ♂ 31,5 ♀ 25 ♂ 28 Recipients of the Heart Valve Grafts from Elderly Organ Donors* ( ) *from 65 to 70 years of age **without morphological and functional alteration of the graft 1 year after replacement

These results clearly demonstrate, that heart valve grafts from organ donors between 65 and 70 years of age can safly be used with good longterm success Conclusion

Klinik für Thorax-, Herz- und Gefäßchirurgie, Johann Wolfgang Goethe-Universität Frankfurt am Main Deutsche Gesellschaft für Gewebespende, Hannover Bio Implant Services, Leiden Klinik für Herz- und thorakale Gefäßchirurge, Universitätsklinikum Schleswig-Holstein Campus Lübeck Deutsches Herzzentrum München Universitair Medisch Centrum St. Radboud, Nijmegen Erasmus Universitair Medisch Centrum, Rotterdam Klinik für Thoax- und Herz-Gefäßchirurgie, Universitätsklinikum des Saarlandes Sana Herzchirurgie Stuttgart Acknowledgement