The effect of recipient's age on lung transplant outcome

Am J Transplant. 2007 May;7(5):1271-7. doi: 10.1111/j.1600-6143.2006.01681.x.


Selection criteria for organ transplantation have evolved over time. Age has been revisited periodically. We studied the outcome of lung transplant adjusted by age in a single center transplant population. We matched the 42 lung graft recipients older than 60 years transplanted by July 1999 to younger controls by lung disease, transplant era within 2 years, type of transplant and gender. The female to male ratios were 17/25 among the older cohort (median age 61.6 years), and 15/27 (median age 51.9 years) among the matched younger. Survival analysis demonstrated a significant difference: at 1 year, 60% versus 86%, and at 5 years, 37% versus 57%, for older and younger, respectively, p=0.005. Excess annual mortality, calculated with the declining exponential approximation to life expectancy (DEALE), showed an older/younger ratio of 1.9. Eleven deaths occurred within 6 months among the older patients, 10 due to infection. After 6 months, there were 20 more deaths, 6 due to malignancy, 5 to Bronchiolitis Obliterans Syndrome (BOS), 3 to infection and 6 to other causes. Among the younger there were 6 deaths within 6 months and 12 more thereafter; among the latter, 8 were due to BOS. Despite stringent selection, lung transplant recipients older than 60 years show increased mortality even after adjusting for their expected higher age-related mortality.

MeSH terms

  • Adult
  • Age Factors
  • Bronchiolitis Obliterans / etiology
  • Bronchiolitis Obliterans / mortality
  • Case-Control Studies
  • Cohort Studies
  • Data Interpretation, Statistical
  • Female
  • Graft Rejection / physiopathology
  • Humans
  • Infections / etiology
  • Infections / mortality
  • Length of Stay / statistics & numerical data
  • Lung Transplantation / adverse effects
  • Lung Transplantation / mortality*
  • Lung Transplantation / statistics & numerical data
  • Male
  • Middle Aged
  • Patient Selection*
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Transplantation / physiology*
  • Treatment Outcome