• Sahar A Saddoughi, Ben Dunne, Jose Luis Campo-Canaveral de la Cruz, Philipe Lemaitre, Juan Pablo Diaz Martinez, Tereza Martinu, Laura Donahoe, Marc de Perrot, Andrew F Pierre, Kazuhiro Yasufuku, Thomas K Waddell, Cecilia Chaparro, Marcelo Cypel, Shaf Keshavjee, and Jonathan C Yeung.
• Toronto Lung Transplant Program, Toronto General Hospital, Toronto, Ontario, Canada.
• J. Thorac. Cardiovasc. Surg. 2024 Mar 1; 167 (3): 861868861-868.

ObjectivesTo determine the impact of older donor age (70+ years) on long-term survival and freedom from chronic lung allograft dysfunction in lung transplant (LTx) recipients.MethodsA retrospective single-center study was performed on all LTx recipients from 2002 to 2017 and a modern subgroup from 2013 to 2017. Recipients were stratified into 4 groups based on donor lung age (<18, 18-55, 56-69, ≥70 years). Donor and recipient characteristics were compared using χ2 tests for differences in proportions and analysis of variance for differences in means. Univariable and multivariable Cox regression was used to describe differences in long-term survival and freedom from chronic lung allograft dysfunction.ResultsBetween 2002 and 2017, 1600 LTx were performed, 98 of which were performed from donors aged 70 years or older. Recipients of 70+ years donor lungs were significantly older with a mean age of 55.5 ± 12.9 years old (P = .001) and had more Status 3 (urgent) recipients (37.4%, P = .002). After multivariable regression, there were no significant differences in survival or freedom from chronic lung allograft dysfunction between the 4 strata of recipients.ConclusionsLung transplantation using donors 70 years old or older can be considered when all other parameters suggest excellent donor lung function without compromising short- or long-term outcomes.Copyright © 2023 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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