Abstract
Age 65years and older is generally considered a relative contraindication to lung transplantation. We sought to define the short and medium term outcome of LTx in patients aged 65 years older vs. less than 65 years old.
We retrospectively reviewed our database and identified 105 patients who underwent LTx between 04/2007 and 11/2011. Follow up analysis was censored on 11/2012. Time of LTx,33 patients were 65 years or older, and 72 patients younger than 65 years. The demographic, postoperative characteristics and survival of the 2 groups were compared.
During this period, 94 (89.5%) double and 11 (10.5%) single LTx were performed; 43 female & 62 male recipients. Majority indication, 39% COPD, 36% PF, 12% CF. Of the 11 single LTx, 6 (54.5%) and 5 (45.4%) were implanted in ≥65 yo and <65 yo, respectively. Death occured in 51.3% of the BOS group vs. 22.7% of the non-BOS group. BOS, but not age, was associated with death, p=0.003. Survival was similar between groups (older 94% vs younger 86%, 1-year; older 86% vs younger 79%, 2-year). [figure 1]
LTx can be performed in patients older than 65 years with acceptable short- and medium-term survival. This cohort is well selected, with limited comorbid conditions, likely biasing overall outcome. Uniquely, our center favors bilateral lung transplantation in the majority of our recipients, regardless of age. Similarities of the early- and medium-term survival and freedom from BOS between groups might be due to type II error (small sample size), donor and recipient selection and management, or both. Additional longitudinal follow up is needed at 3-years and 5-years to better evaluate long-term clinical outcomes.