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  11. Increased Donor Organ Size And Age Is Associated With Reduced Survival In Female Lung Transplant Recipients

Increased Donor Organ Size and Age is Associated with Reduced Survival in Female Lung Transplant Recipients

Isabelle Moneke1, Axel Semmelmann2, Ecem Deniz Ogutur1

  • 1Department of Thoracic Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Transplantation Proceedings
|July 24, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Organ size and age mismatches impact lung transplant outcomes. Female recipients receiving larger, older donor lungs face reduced long-term survival, highlighting the need for careful organ selection in lung transplantation.

Area of Science:

  • Transplantation immunology
  • Thoracic surgery
  • Pulmonary medicine

Background:

  • Organ selection remains a critical, debated aspect of lung transplantation (LTx).
  • Understanding donor-recipient characteristic impacts is vital for optimizing LTx outcomes.
  • This study investigates mismatches in donor organ size, age, and recipient gender.

Purpose of the Study:

  • To analyze the influence of donor-recipient size, age, and gender mismatches on early and long-term outcomes following lung transplantation.
  • To identify specific donor-recipient characteristics associated with primary graft dysfunction and survival.
  • To evaluate potential differences in outcomes based on recipient gender.

Main Methods:

  • Retrospective analysis of donor and recipient data from 203 double lung transplantations (LTx) performed between March 2003 and December 2021.

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  • Statistical analysis was conducted using SPSS and GraphPad software to assess correlations and significance.
  • Key metrics included organ size (oversizing), donor age, recipient gender, Primary Graft Dysfunction (PGD) grades, and long-term survival.

    • Main Results:

    • Oversizing donor lungs by 10-20% decreased severe PGD (grades 2-3) incidence (15% vs. 41%, P=.03).
    • Increased donor age correlated with reduced long-term survival (P=.013).
    • Female recipients received older donor lungs (median 57 vs. 46 years, P=.0003) and had worse long-term survival (P=.02), particularly with >20% organ oversizing.

    Conclusions:

    • Donor age and size mismatches significantly affect lung transplant recipient organ function and survival.
    • Female recipients are at higher risk for unfavorable long-term outcomes when receiving larger and older donor lungs.
    • Multicenter studies are recommended to further validate these findings and refine organ selection criteria for lung transplantation.