Abstract
The prevalence of elderly patients undergoing lung transplantation continues to increase. We aimed to explore outcomes of lung transplantation in older age groups.
Records of patients undergoing bilateral lung transplantation at a single institution from April 13, 2007, to March 7, 2023, were retrospectively reviewed. Patient characteristics and outcomes were compared by univariate and multivariate methods.
A total of 970 patients were identified: 480 (49.5%), 277 (28.6%), 191 (19.7%), and 22 (2.3%) were aged 15 to 64 years, 65 to 69 years, 70 to 74 years, and 75 to 79 years, respectively. Older groups showed increasing rates of male sex, White race, and restrictive lung disease (P < .001). Younger recipients required ventilatory support at listing more often (P < .001). Postoperatively, younger groups had shorter lengths of stay but higher rates of extracorporeal membrane oxygenation at 72 hours (P < .001). One-year survival was similar in the age groups of 15 to 64 years, 65 to 69 years, and 70 to 74 years. The age group of 15 to 64 years had the highest median survival (15-64 years, 6.10 years; 65-69 years, 4.78 years; 70-74 years, 4.65 years; 75-79 years, 4.46 years; P < .001). The 5-year survival rate was 58.0%, 46.8%, 44.5%, and 47.2% for patients aged 15 to 64 years, 65 to 69 years, 70 to 74 years, and 75 to 79 years, respectively.
Recipients aged 65 years and older and their younger counterparts had similar short-term outcomes. Advanced recipient age was associated with less favorable but acceptable long-term survival. In addition, the age groups of 65 to 69 years, 70 to 74 years, and 75 to 79 years had similar short- and long-term outcomes. Careful selection of older recipients is associated with improved perioperative outcomes and short-term survival.
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