• Annals of surgery · Sep 2023

    Lung Transplant Outcome from Selected Older Donors (≥70 Y) Equals Younger Donors (<70 Y): A Propensity-matched Analysis‡.

    • Cedric Vanluyten, Christelle M Vandervelde, Robin Vos, Jan Van Slambrouck, Steffen Fieuws, Paul De Leyn, Philippe Nafteux, Herbert Decaluwé, Hans Van Veer, Lieven Depypere, Yanina Jansen, An-Lies Provoost, Arne P Neyrinck, Catherine Ingels, Bart M Vanaudenaerde, Laurent Godinas, Lieven J Dupont, Geert M Verleden, Dirk Van Raemdonck, and Laurens J Ceulemans.
    • Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium.
    • Ann. Surg. 2023 Sep 1; 278 (3): e641e649e641-e649.

    ObjectiveTo describe our experience with lung transplantation (LTx) from donors ≥70 years and compare short and long-term outcomes to a propensity-matched cohort of donors <70 years.BackgroundAlthough extended-criteria donors have been widely used to enlarge the donor pool, the experience with LTx from older donors (≥70 years) remains limited.MethodsAll single-center bilateral LTx between 2010 and 2020 were retrospectively analyzed. Matching (1:1) was performed for the donor (type, sex, smoking history, x-ray abnormalities, partial pressure of oxygen/fraction of inspired oxygen ratio, and time on ventilator) and recipient characteristics (age, sex, LTx indication, perioperative extracorporeal life support, and cytomegalovirus mismatch). Primary graft dysfunction grade-3, 5-year patient, and chronic lung allograft dysfunction-free survival were analyzed.ResultsOut of 647 bilateral LTx, 69 were performed from donors ≥70 years. The mean age in the older donor cohort was 74 years (range: 70-84 years) versus 49 years (range: 12-69 years) in the matched younger group. No significant differences were observed in the length of ventilatory support, intensive care unit, or hospital stay. Primary graft dysfunction-3 was 26% in the older group versus 29% in younger donor recipients ( P = 0.85). Reintervention rate was comparable (29% vs 16%; P = 0.10). Follow-up bronchoscopy revealed no difference in bronchial anastomotic complications ( P = 1.00). Five-year patient and chronic lung allograft dysfunction-free survivals were 73.6% versus 73.1% ( P = 0.72) and 51.5% versus 59.2% ( P = 0.41), respectively.ConclusionsLTx from selected donors ≥70 years is feasible and safe, yielding comparable short and long-term outcomes in a propensity-matched analysis with younger donors (<70 years).Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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