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Tytuł:
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Lung transplantation with lungs from older donors: an analysis of survival in elderly recipients.
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Autorzy:
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Katsnelson J; Department of Pediatrics, The Ohio State University, Nationwide Children's Hospital, Columbus, Ohio. Electronic address: .
Whitson BA; Department of Surgery, The Ohio State University, Columbus, Ohio.
Tumin D; Department of Pediatrics, The Ohio State University, Nationwide Children's Hospital, Columbus, Ohio; Department of Anesthesiology and Pain Medicine, The Ohio State University, Nationwide Children's Hospital, Columbus, Ohio.
Ravi Y; Division of Cardiothoracic Surgery, Baylor Scott and White Heart and Vascular Institute, Temple, Texas.
Kilic A; Department of Surgery, The Ohio State University, Columbus, Ohio.
Tobias JD; Department of Anesthesiology and Pain Medicine, The Ohio State University, Nationwide Children's Hospital, Columbus, Ohio.
Sai-Sudhakar CB; Department of Surgery, The Ohio State University, Columbus, Ohio.
Hayes D Jr; Department of Pediatrics, The Ohio State University, Nationwide Children's Hospital, Columbus, Ohio; Department of Surgery, The Ohio State University, Columbus, Ohio; Department of Medicine, The Ohio State University, Columbus, Ohio.
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Źródło:
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The Journal of surgical research [J Surg Res] 2017 Jun 15; Vol. 214, pp. 109-116. Date of Electronic Publication: 2017 Mar 06.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: New York, NY : Academic Press
Original Publication: Philadelphia [etc.]
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MeSH Terms:
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Donor Selection/*methods
Lung Transplantation/*mortality
Age Factors ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Outcome Assessment, Health Care ; Registries ; Retrospective Studies ; Survival Analysis
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Contributed Indexing:
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Keywords: Age; Donor; Lung transplantation; Recipient; Survival
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Entry Date(s):
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Date Created: 20170619 Date Completed: 20170919 Latest Revision: 20220330
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Update Code:
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20240105
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DOI:
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10.1016/j.jss.2017.02.059
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PMID:
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28624031
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Background: The average ages of lung transplant (LTx) recipients and donors are increasing. With older recipients considered to be especially at high risk of posttransplant mortality, we sought to determine whether the use of allografts from older donors affects survival among older patients undergoing LTx.
Methods: The United Network for Organ Sharing registry was used to identify patients aged 65-80 y receiving a first-time LTx between 1987 and 2013. Survival analysis examined implications of a donor-recipient age difference >10 y using Cox proportional hazards regression.
Results: The cohort selected for analysis included 3227 elderly LTx recipients, of whom 263 (8.15%) had donors within 10 y of their age at transplantation. Univariate Cox models found no differences with LTx involving donors at least 10 y younger than the recipient with respect to overall survival (hazard ratio = 0.979; 95% confidence interval [CI] = 0.807-1.188; P = 0.831) or conditional survival past 1 y (hazard ratio = 1.067; 95% CI = 0.819-1.391; P = 0.629) relative to LTx involving donors within 10 y of an elderly recipient's age. These findings were substantiated in multivariate analysis adjusting for potential confounders.
Conclusions: In elderly LTx recipients aged 65-80 y at transplantation, intermediate-term survival was not influenced by donor age. For the viable elderly LTx candidate, a carefully selected older donor should be considered to increase donor availability.
(Copyright © 2017 Elsevier Inc. All rights reserved.)
