• Christopher T Holley, Rosemary F Kelly, Sara J Shumway, Roland Z Brown, Marshall I Hertz, Kyle D Rudser, Coco W Quinlan, Irena Cich, and Gabriel Loor.
• Department of Surgery, University of Minnesota, Minneapolis, Minn.
• J. Thorac. Cardiovasc. Surg. 2017 Dec 1; 154 (6): 2126-2133.e2.

BackgroundWe sought to clarify the effect of donor age as a continuous variable on morbidity and mortality in a single-institution experience.MethodsFrom 1986 to 2016, 882 adult lung transplants were performed, including 396 in the lung allocation score era. Kaplan-Meier curves and Cox proportional hazards models were used to evaluate the association of donor age with overall survival and bronchiolitis obliterans syndrome (BOS) score ≥1-free survival. Logistic regression was used to evaluate the association with primary graft dysfunction grade 3. Natural cubic splines were used to explore donor age in a continuous fashion to allow for nonlinear relationships.ResultsIn the lung allocation score era, unadjusted 5-year survival was not significantly different between 3 a priori-defined donor age groups: age <40, 40 to 54, and age ≥55 years (64%, 61%, and 69%, P = .8). Unadjusted 5-year freedom from BOS ≥1 was not significantly different (34%, 20%, and 33%, respectively, P = .1). After we adjusted for comorbidities, cubic spline analysis demonstrated no effect between donor age as a continuous variable and hazard for mortality at 5 years. Similarly, no interaction was seen between donor age and risk of BOS or primary graft dysfunction 3. Adjusted analysis of all 882 transplants pre- and postinception of the lung allocation score also showed no effect of age on 10-year survival.ConclusionsLong-term survival of lung transplant recipients was not affected by the age of the donor. These findings support the notion that donor age could be relaxed.Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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