title: The effect of recipient's age on lung transplant outcome.
abstract: 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.
authors: Toronto General Hospital, Respirology-Lung Transplantation, University of Toronto, Medicine, Toronto, ON, Canada.
authors: C
authors: C
authors: Gutierrez
authors: S
authors: S
authors: Al-Faifi
authors: C
authors: C
authors: Chaparro
authors: T
authors: T
authors: Waddell
authors: D
authors: D
authors: Hadjiliadis
authors: L
authors: L
authors: Singer
authors: S
authors: S
authors: Keshavjee
authors: M
authors: M
authors: Hutcheon
mesh_terms: D000328:Adult; D000367:Age Factors; D001989:Bronchiolitis Obliterans / Q000209:etiology / Q000401:mortality; D016022:Case-Control Studies; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D005260:Female; D006084:Graft Rejection / Q000503:physiopathology; D006801:Humans; D007239:Infections / Q000209:etiology / Q000401:mortality; D007902:Length of Stay / Q000706:statistics & numerical data; D016040:Lung Transplantation / Q000009:adverse effects / Q000401:mortality* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014180:Transplantation / Q000502:physiology*; D016896:Treatment Outcome