Lung Transplantation in Patients 60 Years and Older: Results, Complications, and Outcomes

Philip W. Smith, Hongkun Wang, Vamsi Parini, Jason S. Zolak, K. Robert Shen, Thomas M. Daniel, Mark K. Robbins, Curtis G. Tribble, Irving L. Kron, David R. Jones

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Background: Advanced recipient age is reported to negatively affect survival after lung transplantation (LTX). We hypothesized that LTX in patients aged ≥60 years could be performed with acceptable outcomes. Methods: We identified 182 consecutive LTX recipients from 1995 to 2005. Outcomes were analyzed and survival compared with results in recipients aged <60, as well as with United Network for Organ Sharing (UNOS) registry outcomes for the same age and study period. Actuarial survivals were calculated by the Kaplan-Meier method. Results: During the study period, 29% (52/182) of LTX recipients were ≥60 years old (range, 60 to 69 years). Median follow-up was 2.9 years (range, 0 to 10 years). All patients but one received a single lung. Indications included chronic obstructive pulmonary disease in 63% (33/52), idiopathic pulmonary fibrosis in 27% (14/52), and other in 10% (5/52). In-hospital mortality was 12% (6/52) for those aged ≥60 compared with 7% (9/130) for those aged <60 (p = NS). Complications included reoperation in 10% (5/52), requirement for extracorporeal membrane oxygenation in 6% (3/52), renal failure in 12% (6/52), and stroke in 4% (2/52). Actuarial survivals at 30 days, and 1, 3, and 5 years were 90% (82, 98), 86% (76, 96), 71% (56, 85), and 55% (37, 73), respectively. No significant difference in survival was observed between age cohorts for our institutional data by Kaplan-Meier analysis (p = 0.34) or by Cox proportional hazard model (p = 0.15). A significant survival advantage was noted for our institution compared with UNOS for this cohort (p = 0.018). Conclusions: In carefully selected recipients ≥60 years of age, LTX offers acceptable outcomes and survival.

Original languageEnglish (US)
Pages (from-to)1835-1841
Number of pages7
JournalAnnals of Thoracic Surgery
Volume82
Issue number5
DOIs
StatePublished - Nov 2006
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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