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Donor age over 55 is associated with worse outcome in lung transplant recipients with idiopathic pulmonary fibrosis
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Donor age over 55 is associated with worse outcome in lung transplant recipients with idiopathic pulmonary fibrosis
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Journal Article
Donor age over 55 is associated with worse outcome in lung transplant recipients with idiopathic pulmonary fibrosis
2024
Overview
Background
Lung transplantation (LTx) remains the only efficient treatment for selected patients with end-stage pulmonary disease. The age limit for the acceptance of donor organs in LTx is still a matter of debate. We here analyze the impact of donor organ age and the underlying pulmonary disease on short- and long-term outcome and survival after LTx.
Methods
Donor and recipient characteristics of LTx recipients at our institution between 03/2003 and 12/2021 were analyzed. Statistical analysis was performed using SPSS and GraphPad software.
Results
In 230 patients analyzed, donor age ≥ 55 years was associated with a higher incidence of severe primary graft dysfunction (PGD2/3) (46% vs. 31%,
p
= 0.03) and reduced long-term survival after LTx (1-, 5- and 10-year survival: 75%, 54%, 37% vs. 84%, 76%, 69%,
p
= 0.006). Notably, this was only significant in recipients with idiopathic pulmonary fibrosis (IPF) (PGD: 65%, vs. 37%,
p
= 0.016; 1-, 5-, and 10-year survival: 62%, 38%, 16% vs. 80%, 76%, 70%,
p
= 0.0002 respectively). In patients with chronic obstructive pulmonary disease (COPD), donor age had no impact on the incidence of PGD2/3 or survival (21% vs. 27%,
p
= 0.60 and 68% vs. 72%;
p
= 0.90 respectively). Moreover, we found higher
Torque-teno
virus (TTV)-DNA levels after LTx in patients with IPF compared to COPD (X
2
= 4.57,
p
= 0.033). Donor age ≥ 55 is an independent risk factor for reduced survival in the whole cohort and patients with IPF specifically.
Conclusions
In recipients with IPF, donor organ age ≥ 55 years was associated with a higher incidence of PGD2/3 and reduced survival after LTx. The underlying pulmonary disease may thus be a relevant factor for postoperative graft function and survival.
Trial registration number DKRS
DRKS00033312.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
Subject
/ Age
/ Aged
/ Analysis
/ Chronic obstructive pulmonary disease
/ Complications and side effects
/ Female
/ Fibrosis
/ Humans
/ Idiopathic pulmonary fibrosis
/ Idiopathic Pulmonary Fibrosis - mortality
/ Idiopathic Pulmonary Fibrosis - surgery
/ Lungs
/ Male
/ Medicine
/ Pneumology/Respiratory System
/ Primary Graft Dysfunction - epidemiology
/ Primary Graft Dysfunction - mortality
/ Survival
