Lung transplantation with lungs from older donors: an analysis of survival in elderly recipients

Katsnelson, Jacob; Whitson, Bryan A.; Tumin, Dmitry; Ravi, Y.; Kilic, Ahmet; Tobias, Joseph D.; Sai-Sudhakar, Chittoor; Hayes, Don

doi:10.1016/j.jss.2017.02.059

Cited by 16 publications

(9 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…263 donors (8.15%) were within 10 years of their recipient's age at transplantation. There was no difference in overall or intermediate conditional survival past 1 year between groups [27]. The reason for this may be the larger data set included in the ISHLT analysis (over 30,000 patients in the ISHLT analysis vs 3227 in Katsnelson's report).…”

Section: Donor Agementioning

confidence: 82%

Review 1: Lung transplant—from donor selection to graft preparation

et al. 2020

View full text Add to dashboard Cite

For various end-stage lung diseases, lung transplantation remains one of the only viable treatment options. While the demand for lung transplantation has steadily risen over the last few decades, the availability of donor grafts is limited, which have resulted in progressively longer waiting lists. In the early years of lung transplantation, only the 'ideal' donor grafts are considered for transplantation. Due to the donor shortages, there is ongoing discussion about the safe use of 'suboptimal' grafts to expand the donor pool. In this review, we will discuss the considerations around donor selection, donor-recipient matching, graft preparation and graft optimisation.

show abstract

Section: Donor Agementioning

confidence: 82%

Review 1: Lung transplant—from donor selection to graft preparation

et al. 2020

View full text Add to dashboard Cite

show abstract

“…There are many examples where donations outside these ideal parameters (so-called extended criteria donors) are now routinely performed, such as donation after (controlled) circulatory death donation [ 12 ]. Similarly, successful use has been made of older donors [ 12 , 13 ], and donors with lower P aO 2 [ 13 ], positive cultures [ 13 – 15 ] or pulmonary emboli [ 13 ].…”

Section: Can We Use These Organs?mentioning

confidence: 99%

Controversies and emerging topics in lung transplantation

Abelson

Glanville

2018

Breathe

View full text Add to dashboard Cite

Lung transplantation provides a realistic hope of improved survival and enhanced quality of life. However, outcomes can be disappointing, meaning many decisions are highly controversial. Practice is largely based on expert opinion and there is a dearth of high-level evidence. Not surprisingly, this leads to centre-specific practices that may vary considerably in controversial areas. The aim of this review, therefore, is to explore some of those domains and present the available evidence. As the science of lung transplantation approaches its fifth decade, we are only now reaching a critical mass of clinicians and scientific researchers to enable adequately powered studies to assist in informing our approach to some of these controversies.Key pointsLung transplantation remains an art, combining experience with evidence.Clinicians need evidence to guide them on a myriad of questions, from candidate selection and listing, to organ donor acceptance, immunosuppression and chronic allograft dysfunction.Chronic lung allograft dysfunction pathogenesis deserves further detailed study.Educational aimsTo illustrate the spectrum of controversial areas in lung transplantation including whom to list, which organs can be used and for whom, immune suppression and infection prophylaxis, and causes and phenotypes of chronic lung allograft dysfunction.To inspire clinicians to always ask questions and help collect the evidence we need to inform decision making.

show abstract

“…Age of donor and recipient Sheikh et al, 1 Yeung et al, 2 Crawford et al, 3 Mulvihill et al, 4 Hayes et al 5 Association between increasing age and decreasing likelihood of survival after LTX Katsnelson et al 7 No outcome difference in recipients who received lungs from older donors closer to age of recipient Pulmonary hypertension Avriel et al 9 PAH patients with concomitant diastolic dysfunction had worse survival and greater likelihood of post-LTX ECMO support Hayes et al 5 COPD patients with preoperative PAH had a higher incidence of mortality than COPD patients without PAH Obesity and BMI Jomphe et al 12 Potential LTX recipients with BMI >30 had increased mortality if unable to decrease BMI to <30 pre-LTX Crawford et al, 3 Hayes Jr et al 5 Increasing mortality risk associated with increasing BMI Repeat LTX surgery…”

Section: Topicmentioning

confidence: 99%

“…Katsnelson et al 7 conducted a retrospective review utilizing the UNOS registry focusing on LTX patients 65 to 80 years old. Their aim was to determine whether there was a relationship between donor age and survival of older recipients.…”

Section: Noteworthy Literature Published In 2017 On Lung Transplantationmentioning

confidence: 99%