In the evaluation for heart transplantation, which factor most commonly reduces candidacy in older adults?

• A. Advanced age
• B. Normal kidney function
• C. Excellent functional status
• D. No comorbidities

Answer: (A)

In heart transplantation evaluation, the ability to tolerate a major operation and lifelong immunosuppression hinges on physiologic reserve and overall health. In older adults, advanced age tends to reduce candidacy because aging is associated with diminished organ reserve, increased frailty, and a higher likelihood of comorbidities that raise perioperative risk and the chance of poor post-transplant outcomes. While age alone isn’t an absolute disqualifier, it is the factor most likely to limit candidacy in older patients. By contrast, normal kidney function, excellent functional status, and no comorbidities would support candidacy rather than reduce it.