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Area of Science:

  • Transplant Surgery
  • Gerontology
  • Public Health

Background:

  • Age is a recognized factor influencing long-term survival rates following lung transplantation.
  • Investigating age-related disparities in post-transplant outcomes is essential for improving patient care.

Purpose of the Study:

  • To analyze the impact of age on long-term survival after lung transplantation.
  • To identify age-specific risk factors associated with mortality in lung transplant recipients.

Main Methods:

  • Utilized data from the Scientific Registry of Transplant Recipients (SRTR) for adult lung transplant recipients (≥18 years) from 2006-2015.
  • Employed nonproportional hazard models and random-survival forest methodology to assess survival and identify risk factors.
  • Analyzed age as both a continuous and categorical variable (<30, 30-55, >55 years).

Main Results:

  • Age was the most significant risk factor for death, with its impact increasing over time post-transplant.
  • Key risk factors for mortality included extremes of age, elevated creatinine and bilirubin, single lung transplants, and pre-transplant hospitalization.
  • Social determinants of health disproportionately affected survival in the youngest recipient age group.

Conclusions:

  • Both the youngest and oldest adult lung transplant recipients exhibit the lowest posttransplant survival.
  • Divergent pathways contribute to reduced survival in these age extremes, highlighting potential intervention points.
  • Targeted interventions based on age-specific risk factors may improve overall lung transplant survival rates.