TY - JOUR
T1 - Lung Transplantation in Patients 60 Years and Older
T2 - Results, Complications, and Outcomes
AU - Smith, Philip W.
AU - Wang, Hongkun
AU - Parini, Vamsi
AU - Zolak, Jason S.
AU - Shen, K. Robert
AU - Daniel, Thomas M.
AU - Robbins, Mark K.
AU - Tribble, Curtis G.
AU - Kron, Irving L.
AU - Jones, David R.
PY - 2006/11
Y1 - 2006/11
N2 - Background: Advanced recipient age is reported to negatively affect survival after lung transplantation (LTX). We hypothesized that LTX in patients aged ≥60 years could be performed with acceptable outcomes. Methods: We identified 182 consecutive LTX recipients from 1995 to 2005. Outcomes were analyzed and survival compared with results in recipients aged <60, as well as with United Network for Organ Sharing (UNOS) registry outcomes for the same age and study period. Actuarial survivals were calculated by the Kaplan-Meier method. Results: During the study period, 29% (52/182) of LTX recipients were ≥60 years old (range, 60 to 69 years). Median follow-up was 2.9 years (range, 0 to 10 years). All patients but one received a single lung. Indications included chronic obstructive pulmonary disease in 63% (33/52), idiopathic pulmonary fibrosis in 27% (14/52), and other in 10% (5/52). In-hospital mortality was 12% (6/52) for those aged ≥60 compared with 7% (9/130) for those aged <60 (p = NS). Complications included reoperation in 10% (5/52), requirement for extracorporeal membrane oxygenation in 6% (3/52), renal failure in 12% (6/52), and stroke in 4% (2/52). Actuarial survivals at 30 days, and 1, 3, and 5 years were 90% (82, 98), 86% (76, 96), 71% (56, 85), and 55% (37, 73), respectively. No significant difference in survival was observed between age cohorts for our institutional data by Kaplan-Meier analysis (p = 0.34) or by Cox proportional hazard model (p = 0.15). A significant survival advantage was noted for our institution compared with UNOS for this cohort (p = 0.018). Conclusions: In carefully selected recipients ≥60 years of age, LTX offers acceptable outcomes and survival.
AB - Background: Advanced recipient age is reported to negatively affect survival after lung transplantation (LTX). We hypothesized that LTX in patients aged ≥60 years could be performed with acceptable outcomes. Methods: We identified 182 consecutive LTX recipients from 1995 to 2005. Outcomes were analyzed and survival compared with results in recipients aged <60, as well as with United Network for Organ Sharing (UNOS) registry outcomes for the same age and study period. Actuarial survivals were calculated by the Kaplan-Meier method. Results: During the study period, 29% (52/182) of LTX recipients were ≥60 years old (range, 60 to 69 years). Median follow-up was 2.9 years (range, 0 to 10 years). All patients but one received a single lung. Indications included chronic obstructive pulmonary disease in 63% (33/52), idiopathic pulmonary fibrosis in 27% (14/52), and other in 10% (5/52). In-hospital mortality was 12% (6/52) for those aged ≥60 compared with 7% (9/130) for those aged <60 (p = NS). Complications included reoperation in 10% (5/52), requirement for extracorporeal membrane oxygenation in 6% (3/52), renal failure in 12% (6/52), and stroke in 4% (2/52). Actuarial survivals at 30 days, and 1, 3, and 5 years were 90% (82, 98), 86% (76, 96), 71% (56, 85), and 55% (37, 73), respectively. No significant difference in survival was observed between age cohorts for our institutional data by Kaplan-Meier analysis (p = 0.34) or by Cox proportional hazard model (p = 0.15). A significant survival advantage was noted for our institution compared with UNOS for this cohort (p = 0.018). Conclusions: In carefully selected recipients ≥60 years of age, LTX offers acceptable outcomes and survival.
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U2 - 10.1016/j.athoracsur.2006.05.036
DO - 10.1016/j.athoracsur.2006.05.036
M3 - Article
C2 - 17062257
AN - SCOPUS:33750051647
SN - 0003-4975
VL - 82
SP - 1835
EP - 1841
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 5
ER -