PURPOSE: Lung organ scarcity and increasing waiting time for lung transplant has led to acceptance of organs under the extended-donor criteria. However, long-term effects of lung transplants with older donors are not well known. Older donor age has been suggested to be associated with early graft dysfunction as well as bronchiolitis obliterans (BOS). In this study, we investigated the impact of donor age over 55 years in lung transplantation.
METHODS: In this retrospective study, 297 consecutive lung transplants from January 2002 to February 2010 were evaluated. A total of 15 recipients received lungs from donors aged 55 years or older (range 55-63 years,Group A) and 282 received lungs from younger donors (range 12-54,Group B). 30-day, 90-day and 1-year mortality was evaluated for both the groups.
RESULTS: All the 15 patients in group A received double lung transplants. 30-day mortality in group A was 6.67% compared to 8.86% in group B (p-value=0.769). 90-day mortality Group A was 13.33% and 13.12% in group B (p-value=0.981). 1-year mortality in group A was 20% and was 23.63% in Group B (p-value=0.791). Cumulative survival rate at 5 yrs for Group A was 50%. Cause of death showed no differences in both groups. Spirometry data available on 5 patients at 3 yrs in group A showed no BOS.
CONCLUSION: In our experience, the data suggests no differences in the outcome of lung-transplanted patients with organs from donors >55 years. There was no difference in 30-day, 90-day and 1-year survival among two groups. 5-year cumulative survival rate of 50% in the older donor group is similar to the ISHLT registry (53.5%). Increased BOS occurrence in older donor age group was not seen.
CLINICAL IMPLICATIONS: Donor age >55 years does not compromise immediate results after lung transplantation and long-term effects have yet to be proven. Due to paucity of organs, lungs from older donors can be safely used. However, the acceptance should be based on donor lung evaluation and individual recipient needs. Longterm outcomes need to be further investigated.
DISCLOSURE: Amarbir Mattewal, No Financial Disclosure Information; No Product/Research Disclosure Information