Lung Transplantation in the Elderly: Is Age a Contraindication?

Area of Science:

• Cardiology
• Pulmonology
• Transplant Surgery

Background:

• Increasing prevalence of elderly patients undergoing lung transplantation.
• Need to explore outcomes in older age groups for lung transplant recipients.

Purpose of the Study:

• To compare lung transplantation outcomes in older versus younger patient groups.
• To evaluate the impact of advanced recipient age on short- and long-term survival.

Main Methods:

• Retrospective review of bilateral lung transplantation records from April 2007 to March 2023.
• Comparison of patient characteristics and outcomes using univariate and multivariate analyses.
• Stratification of patients into age groups: 15-64, 65-69, 70-74, and 75-79 years.

Main Results:

• Older recipients showed higher rates of male sex, White race, and restrictive lung disease.
• Younger recipients more frequently required ventilatory support pre-transplant.
• One-year survival was similar across age groups (15-74 years); median survival decreased with advanced age.
• Five-year survival rates ranged from 44.5% to 58.0%, with older groups showing slightly lower rates.

Conclusions:

• Short-term outcomes for lung transplantation are similar between recipients aged 65 and older and younger patients.
• Advanced recipient age is linked to less favorable but acceptable long-term survival.
• Careful selection of older lung transplant recipients can improve perioperative outcomes and short-term survival.