Outcomes after lung transplantation in recipients aged 70 years or older

Abstract

Background:The proportion of lung transplant (LTx) recipients older than 70 years is increasing, thus we assessed long-term survival after LTx in this cohort relative to younger counterparts. Patients and methods:We retrospectively reviewed charts of patients who underwent LTx between 2012 and 2016 at our center and divided patients by age: group A (<65 years), B (65-69 years), and C (≥70 years). Survival statistics were evaluated using the Kaplan-Meier method and Cox regression. Results:The study included 375 LTx recipients: 221 (58.9%) in group A, 109 (29.1%) in group B, and 45 (12.0%) in group C. Group C was mostly men (37/45 [82.2%]; P = 0.003) and had the highest mean serum creatinine at listing (P = 0.02). Survival at 1, 3, and 5 years after transplant in group A (93.2%, 70.1%, 58.8%) was significantly higher than group B (83.5%, 59.6%, 44.0%; P = 0.005, 0.028, 0.006, log-rank test) and was similar to group C (86.7%, 64.4%, 57.8%), although trended higher at 1 year (P = 0.139, 0.274, 0.489, log-rank test). Groups B and C had comparable survival at all time points. Conclusions:Although survival decreased after age 65, long-term survival was comparable between LTx recipients aged 65-69 years and recipients ≥70 years.

Chirurgie des alten Menschen – Thoraxchirurgie

“…4 ; [ 41 ]). Im Gegensatz dazu berichtete eine aktuelle große Einzelzentrumsstudie, dass prinzipiell ein vergleichbar gutes 5‑Jahres-Überleben für ≥ 70-jährige wie für < 65-jährige PatientInnen möglich ist [ 42 ]. Wie eine Einzelzentrumsstudie demonstrierte, scheinen die zugrunde liegende Lungenerkrankung, das Komorbiditäsprofil und die Spenderlungenqualität bei der Lungentransplantation für das Kurz- und Langzeitüberleben deutlich wichtigere Faktoren zu sein als das steigende Alter an sich [ 43 ].…”

Lung Transplantation Outcomes in Recipients Aged 70 Years or Older and the Impact of Center Volume

“…Recent findings from institutional studies suggest that LTx is a promising treatment option for elderly patients [ 7 , 8 , 11 ]. Improved patient survival after LTx reflects advances in surgical techniques, post-operative care, and effective immunosuppressants, indicating that advanced age alone is not necessarily an insurmountable barrier to successful LTx [ 12 , 13 ].…”

Time is ticking: the role of time after primary transplant and functional impairment on survival after redo lung transplant

“…Although traditionally, numerical age thresholds have served as relative and absolute contraindications to primary LTx based on consensus statements from the International Society for Heart and Lung Transplantation (4), these recommendations are actively being reconsidered (5) in lieu of an aging transplant waiting list as well as practice changes observed in a majority of larger centers, particularly over the last decade. We recently reported our experience in transplanting patients over 70 years of age, finding comparable long-term survival with patients older than 65 years (6). Studies reporting the safety and feasibility of LTx in the elderly seem to warrant a more "holistic" evaluation of patients' "biological" age, emphasizing overall physical and cognitive fitness.…”