title: Is There an Age Limit to Lung Transplantation?
abstract: BACKGROUND
  Lung transplantation in patients older than 65 years is increasingly common, but questions remain regarding risk vs benefit and procedure choice. We identified short-term and long-term outcomes in older single-lung transplant (SLT) and bilateral-lung transplant (BLT) recipients.
  
  
  METHODS
  We performed a retrospective review of United Network for Organ Sharing data for patients who underwent lung transplantation between May 2005 and December 2012. Patients were grouped by age, and we calculated short-term and long-term survival rates and compared survival distributions.
  
  
  RESULTS
  Of the 11,776 patients who received lung transplants, 9,317 (79%) were aged 12 to 64 years, 1,902 (16%) were 65 to 69, 486 (4%) were 70 to 74, and 71 (1%) were 75 to 79. Short-term survival was similar across all age groups and procedure types except those aged 75 to 79, who had lower short-term survival for BLT. Those aged 12 to 64 had higher 5-year survival for SLT and BLT than all other groups (p < 0.001), and BLT offered a long-term survival advantage over SLT in this group (p < 0.0001). Older age groups trended toward better long-term survival for BLT compared with SLT (65 to 69, p = 0.059; 70 to 74, p = 0.079). Although data were lacking for 5-year survival for those aged 75 to 79, the 3-year survival for BLT in this group was inferior.
  
  
  CONCLUSIONS
  Lung transplant can be offered to select older patients up to age 74 with acceptable outcomes. SLT may be preferred for elderly patients, but BLT offers acceptable long-term outcomes without significant short-term risk. Patients older than 75 have acceptable short-term outcomes for SLT, but long-term outcomes for SLT and BLT in this group are poor.
authors.affiliation: Department of General Surgery, Providence Hospital and Medical Center, Southfield, Michigan.
authors.forename: Sreeja
authors.initials: S
authors.lastname: Biswas Roy
authors.affiliation: Division of Thoracic Surgery, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
authors.forename: Diana
authors.initials: D
authors.lastname: Alarcon
authors.affiliation: Division of Thoracic Surgery, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
authors.forename: Rajat
authors.initials: R
authors.lastname: Walia
authors.affiliation: Division of Thoracic Surgery, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
authors.forename: Kristina M
authors.initials: KM
authors.lastname: Chapple
authors.affiliation: Division of Thoracic Surgery, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
authors.forename: Ross M
authors.initials: RM
authors.lastname: Bremner
authors.affiliation: Division of Thoracic Surgery, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona. Electronic address: michael.smith011@dignityhealth.org.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D000075202:Contraindications; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult