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The Effect of Recipient's Age on Lung Transplant Outcome
Author(s) -
Gutierrez C.,
AlFaifi S.,
Chaparro C.,
Waddell T.,
Hadjiliadis D.,
Singer L.,
Keshavjee S.,
Hutcheon M.
Publication year - 2007
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2006.01681.x
Subject(s) - medicine , bronchiolitis obliterans , population , lung transplantation , cohort , life expectancy , lung , transplantation , malignancy , surgery , pediatrics , demography , environmental health , sociology
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.