To analyze the short term outcome after lung transplantation performed in patients above the recommended age of 65 for single lung transplant (SLTx); 60 for double lung transplant (DLTx); and 55 for heart lung transplant (HLTx).
Retrospective analysis of 75 patients who underwent 77 transplantations distributed as follows: SLTx (n=46), DLTx (n=26) or HLTx (n=5). Of these, 21 patients were above the recommended age for the procedure (Average age = 65.3 ± 2.6); and 54 were within the recommended age for the specific type of transplant (Average age = 49.9 ± 11). All patients in the elderly group underwent single or double LTx except one patient who underwent a HLTx at age 61.
There were no significant differences between the groups in terms of hospitalization days; time spent in the intensive care unit or on mechanical ventilation; incidence of acute reperfusion injury; incidence of episodes of acute rejection and 3 and 6 months survival. Infection by cytomegalovirus was significantly more frequent in the elderly group.
Short term outcome of Lung, and possibly heart lung, transplantation in well selected patients above the recommended age is similar to the outcome in patients under the recommended age limits.
Established age limits for lung or heart-lung transplantation should be revised to include patients without significant co-morbidities that exceed the recommended age. Follow-up for longer period of time is needed to determine long term outcome in this group of patients.
Francisco Alvarez, None.