A single-center analysis of lung transplantation outcomes in recipients aged 70 or older
Mohammed Abul Kashem, Hannah Calvelli, Michael Warnick, Hiromu Kehara, Vipin Dulam, Huaqing Zhao, Roh Yanigada, Norihisa Shigemura, Yoshiya Toyoda- Cardiology and Cardiovascular Medicine
- Pulmonary and Respiratory Medicine
- General Medicine
- Surgery
Abstract
OBJECTIVES
As life expectancies continue to increase, a greater proportion of older patients will require lung transplants (LTs). However, there are no well-defined age cutoffs for which LT can be performed safely. At our high-volume LT center, we explored outcomes for LT recipients ≥70 years old versus <70 years old.
METHODS
This is a retrospective single-center study of survival after LT among older recipients. Data were stratified by recipient age (≥70 years old versus <70 years old) and procedure type (single versus double lung transplant). Demographics and clinical variables were compared using Chi-square test and two sample t-test. Survival was assessed by Kaplan–Meier curves and compared by log-rank test with propensity score matching.
RESULTS
988 LTs were performed at our center over 10 years, including 289 LTs in patients ≥70 years old and 699 LTs in patients <70 years old. The recipient groups differed significantly by race (p < 0.0001), sex (p = 0.003), and disease etiology (p < 0.0001). Older patients were less likely to receive a double lung transplant compared to younger patients (p < 0.0001) and had lower rates of intraoperative cardiopulmonary bypass (p = 0.019) and shorter length of stay (p = 0.001). Both groups had overall high 1-year survival (85.8% versus 89.1%, respectively). Survival did not differ between groups after propensity matching (p = 0.15).
CONCLUSIONS
Our data showed high survival for older and younger LT recipients. There were no statistically significant differences observed in survival between the groups after propensity matching, however, a trend in favour of younger patients was observed.