Using Donor Lungs ≥70 Years of Age for Transplantation - Do Long-Term Outcomes Justify the Use? / Sommer, Wiebke; Aburahma, Khalil; Franz, Maximilian; Floethmann, Katharina; Yablonski, P. ; Avsar, Murat; Tudorache, Igor; Greer, Mark; Haverich, Axel; Kuehn, Christian; Salman, Jawad; Warnecke, Gregor; Ius, Fabio.
In: Journal of Heart and Lung Transplantation, Vol. 41, No. 4S, 07.04.2022, p. S194.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Using Donor Lungs ≥70 Years of Age for Transplantation - Do Long-Term Outcomes Justify the Use?
AU - Sommer, Wiebke
AU - Aburahma, Khalil
AU - Franz, Maximilian
AU - Floethmann, Katharina
AU - Yablonski, P.
AU - Avsar, Murat
AU - Tudorache, Igor
AU - Greer, Mark
AU - Haverich, Axel
AU - Kuehn, Christian
AU - Salman, Jawad
AU - Warnecke, Gregor
AU - Ius, Fabio
PY - 2022/4/7
Y1 - 2022/4/7
N2 - PurposeDonor shortage have led transplant centers in the past to extend acceptable criteria for lung donors, accepting older and more marginal donor organs for transplantation. Accepting donors ≥70 years of age as lung donors has shown good short-term outcomes in the past, however, no mid- and long-term outcome data on these extended criteria donors exists thus far.MethodsAll patients undergoing lung transplantation between 06/2010 and 12/2019 at our institution were included into the analysis, that compared outcomes between patients transplanted with donors <70 years of age vs. patients transplanted with donors ≥70 years old. Outcome parameters included pre-, peri- and postoperative clinical parameters as well as recipient overall survival and CLAD-free survival. Median follow-up was 8.9 years.ResultsBetween 06/2010 and 12/2019, among the 1168 lung-transplanted patients, 62 (5.3%) patients received lungs from donors ≥70 years old. Recipient age of the patients receiving older organs was significantly higher as compared to recipients of <70 years old lungs (56.2±7.8 vs. 48.7±38.9 yrs; p<0.0001) and more patients with an obstructive disease pattern prior to transplantation received a donor lung ≥70 years old (40.3% vs. 27.6%; p=0.04). Mean donor age was 73.4±2.9 years in the ≥70 years old group as compared to 44.3±15.8 yrs in the other cohort (p<0.0001). Older donors were significantly shorter on mechanical ventilation prior to donation (4.0±3.6 vs 5.7±5.1 days; p=0.0007), had a higher median Horowitz index (412.5 (356;469) vs. 384 (316; 448); p=0.01) and fewer history of smoking (12.9% vs. 42.1%; p<0.0001).Primary graft dysfunction scores at 24 (p=0.99), 48 (p=0.60) and 72 (p=0.94) hours after transplant showed no significant difference between both groups. Similarly, time on mechanical ventilation (p=0.68), time on ICU (p=0.65) as well as total hospital stay (p=0.58) were comparable in both groups. One-, five- and 7-year survival in both groups showed no significant difference (1yr: 95.1 vs. 90.2%, 5yr: 77.8 vs. 73.2%, 7yr: 69.1 vs. 68.1%, p=0.71). CLAD-free survival showed no difference between both groups in the follow-up period (p=0.76).ConclusionUtilization of donor lungs ≥70 years of age leads to excellent mid- and long-term results that are similar to younger donor organs when carefully preselecting these older donor organs
AB - PurposeDonor shortage have led transplant centers in the past to extend acceptable criteria for lung donors, accepting older and more marginal donor organs for transplantation. Accepting donors ≥70 years of age as lung donors has shown good short-term outcomes in the past, however, no mid- and long-term outcome data on these extended criteria donors exists thus far.MethodsAll patients undergoing lung transplantation between 06/2010 and 12/2019 at our institution were included into the analysis, that compared outcomes between patients transplanted with donors <70 years of age vs. patients transplanted with donors ≥70 years old. Outcome parameters included pre-, peri- and postoperative clinical parameters as well as recipient overall survival and CLAD-free survival. Median follow-up was 8.9 years.ResultsBetween 06/2010 and 12/2019, among the 1168 lung-transplanted patients, 62 (5.3%) patients received lungs from donors ≥70 years old. Recipient age of the patients receiving older organs was significantly higher as compared to recipients of <70 years old lungs (56.2±7.8 vs. 48.7±38.9 yrs; p<0.0001) and more patients with an obstructive disease pattern prior to transplantation received a donor lung ≥70 years old (40.3% vs. 27.6%; p=0.04). Mean donor age was 73.4±2.9 years in the ≥70 years old group as compared to 44.3±15.8 yrs in the other cohort (p<0.0001). Older donors were significantly shorter on mechanical ventilation prior to donation (4.0±3.6 vs 5.7±5.1 days; p=0.0007), had a higher median Horowitz index (412.5 (356;469) vs. 384 (316; 448); p=0.01) and fewer history of smoking (12.9% vs. 42.1%; p<0.0001).Primary graft dysfunction scores at 24 (p=0.99), 48 (p=0.60) and 72 (p=0.94) hours after transplant showed no significant difference between both groups. Similarly, time on mechanical ventilation (p=0.68), time on ICU (p=0.65) as well as total hospital stay (p=0.58) were comparable in both groups. One-, five- and 7-year survival in both groups showed no significant difference (1yr: 95.1 vs. 90.2%, 5yr: 77.8 vs. 73.2%, 7yr: 69.1 vs. 68.1%, p=0.71). CLAD-free survival showed no difference between both groups in the follow-up period (p=0.76).ConclusionUtilization of donor lungs ≥70 years of age leads to excellent mid- and long-term results that are similar to younger donor organs when carefully preselecting these older donor organs
UR - https://www.sciencedirect.com/science/article/abs/pii/S1053249822016461#!
M3 - Article
VL - 41
SP - S194
JO - Journal of Heart and Lung Transplantation
JF - Journal of Heart and Lung Transplantation
SN - 1053-2498
IS - 4S
ER -
ID: 98564016