Lung transplantation with grafts from elderly donors: a single-center experience.
BACKGROUND
Use of extended criteria donors is one of the strategies to face the scarcity of donors for lung transplantation.


METHODS
Between November 2002 and May 2009, we performed 52 LTs in 50 recipients, 10 of whom (group A) received lungs from donors aged 55 years or older (median, 58.5; range, 56-66 years) for comparison with 28 patients (group B) transplanted with lungs from donors younger than 55 years (median, 25.5; range, 15-54 years). We excluded 9 children and 3 recipients of combined liver plus lung transplantations from the study.


RESULTS
Recipient age, gender, and indications for transplantation did not differ significantly between the 2 groups. Neither were there significant differences in PaO2/FiO2 ratios before lung retrieval, or length of the ischemic time The first PaO2/FiO2 on arrival to the intensive care unit (ICU) and the median length of ICU stay were similar. All patients, except 2 who died in the operating theatre, were extubated between 3 and 216 hours after the transplantation. Hospital mortality was similar in both groups: 3 patients in group A and 2 in group B (P = .1). The median portions of the predicted 1-second forced expiratory volume (FEV1) at 6 months after transplantation did not differ in the 2 groups: 62.4% in group A versus 70% in group B (P = .85).


CONCLUSIONS
Lung grafts from donors older than 55 years can be effectively used for transplantation, thus increasing the total organ pool.
Dezza
M C
MC
Chirurgia III, Centro Trapianto di Fegato e di Polmone, Ospedali Riuniti di Bergamo, Italy.
Parigi
P C
PC
Corno
V
V
Lucianetti
A
A
Pinelli
D
D
Zambelli
M
M
Guizzetti
M
M
Aluffi
A
A
Tagliabue
F
F
Platto
M
M
Codazzi
D
D
Triggiani
M
M
Colledan
M
M
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002315:Cardiopulmonary Bypass; D002423:Cause of Death; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D016031:Liver Transplantation / Q000502:physiology; D016040:Lung Transplantation / Q000401:mortality / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D020521:Stroke / Q000453:epidemiology / Q000401:mortality; D014019:Tissue Donors / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult