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

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

Research output: Contribution to journalArticle

Abstract

Background The average ages of lung transplant (LTx) recipients and donors are increasing. With older recipients considered to be especially at high risk of posttransplant mortality, we sought to determine whether the use of allografts from older donors affects survival among older patients undergoing LTx. Methods The United Network for Organ Sharing registry was used to identify patients aged 65-80 y receiving a first-time LTx between 1987 and 2013. Survival analysis examined implications of a donor-recipient age difference >10 y using Cox proportional hazards regression. Results The cohort selected for analysis included 3227 elderly LTx recipients, of whom 263 (8.15%) had donors within 10 y of their age at transplantation. Univariate Cox models found no differences with LTx involving donors at least 10 y younger than the recipient with respect to overall survival (hazard ratio = 0.979; 95% confidence interval [CI] = 0.807-1.188; P = 0.831) or conditional survival past 1 y (hazard ratio = 1.067; 95% CI = 0.819-1.391; P = 0.629) relative to LTx involving donors within 10 y of an elderly recipient's age. These findings were substantiated in multivariate analysis adjusting for potential confounders. Conclusions In elderly LTx recipients aged 65-80 y at transplantation, intermediate-term survival was not influenced by donor age. For the viable elderly LTx candidate, a carefully selected older donor should be considered to increase donor availability.

Original languageEnglish (US)
Pages (from-to)109-116
Number of pages8
JournalJournal of Surgical Research
Volume214
DOIs
StatePublished - Jun 15 2017
Externally publishedYes

Keywords

  • Age
  • Donor
  • Lung transplantation
  • Recipient
  • Survival

ASJC Scopus subject areas

  • Surgery

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    Katsnelson, J., Whitson, B. A., Tumin, D., Ravi, Y., Kilic, A., Tobias, J. D., Sai-Sudhakar, C. B., & Hayes, D. (2017). Lung transplantation with lungs from older donors: an analysis of survival in elderly recipients. Journal of Surgical Research, 214, 109-116. https://doi.org/10.1016/j.jss.2017.02.059