Octo- and nonagenarian donors in lung transplantation: A dual center experience

The maximal donor age for lung transplantation (LTx) remains controversial, despite favorable outcomes with donors ≥70 years. We report our experience with LTx from donors ≥80 years. Donor/recipient characteristics and short-term postoperative outcome were retrospectively analyzed across two centers between 2016 and 2023. Seventeen patients underwent single (n=2) or double (n=15) LTx from octo- or nonagenarian donors with a median age of 83 years (range 80-94). Most donors were non-smoking females with intracerebral bleeding. Last donor PaO₂/FiO₂ ratio was 440 mmHg. Three recipients developed PGD3 at 72 h. Median ICU and hospital stay were 11 and 29 days, respectively. Five patients showed minimal (A1) ACR at one month post-LTx. Two patients developed CLAD. One- and three-year survival rates were 84% and 70%. Our case series indicates that LTx from well-selected octo- and nonagenarian donors is a valuable option to expand the donor pool.