title: Survival in Adult Lung Transplant Recipients Receiving Pediatric Versus Adult Donor Allografts.
abstract: BACKGROUND
  Recent evidence showed that pediatric donor lungs increased rates of allograft failure in adult lung transplant recipients; however, the influence on survival is unclear.
  
  
  METHODS
  The United Network for Organ Sharing (UNOS) database was queried from 2005 to 2013 for adult lung transplant recipients (≥18 years) to assess survival differences among donor age categories (<18 years, 18 to 29 years, 30 to 59 years, ≥60 years).
  
  
  RESULTS
  Of 12,297 adult lung transplants, 12,209 were used for univariate Cox models and Kaplan-Meier (KM) analysis and 11,602 for multivariate Cox models. A total of 1,187 adult recipients received pediatric donor lungs compared with 11,110 receiving adult donor organs. Univariate and multivariate Cox models found no difference in survival between donor ages 0 to 17 and donor ages 18 to 29, whereas donor ages 60 and older were significantly associated with increased mortality hazard, relative to the modal category of donor ages 30 to 59 (adjusted hazard ratio = 1.381; 95% confidence interval = 1.188% to 1.606%; p < 0.001). Interactions between recipient and donor age range found that the oldest donor age range was negatively associated with survival among middle-aged (30 to 59) and older (≥60) lung transplant recipients.
  
  
  CONCLUSIONS
  Pediatric donor lung allografts were not negatively associated with survival in adult lung transplant recipients; however, the oldest donor age range was associated with increased mortality hazard for adult lung transplant recipients.
authors.affiliation: Department of Pediatrics, The Ohio State University, Columbus, Ohio; Department of Internal Medicine, The Ohio State University, Columbus, Ohio; Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio. Electronic address: hayes.705@osu.edu.
authors.forename: Don
authors.initials: D
authors.lastname: Hayes
authors.affiliation: Department of Surgery, The Ohio State University, Columbus, Ohio.
authors.forename: Bryan A
authors.initials: BA
authors.lastname: Whitson
authors.affiliation: Department of Internal Medicine, The Ohio State University, Columbus, Ohio; Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio.
authors.forename: Samir N
authors.initials: SN
authors.lastname: Ghadiali
authors.affiliation: Department of Pediatrics, The Ohio State University, Columbus, Ohio; Section of Critical Care Medicine, Nationwide Children's Hospital, Columbus, Ohio.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Lloyd
authors.affiliation: Department of Anesthesiology, The Ohio State University, Columbus, Ohio; Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tobias
authors.affiliation: Skaggs Center of Pharmaceutical Sciences, The University of Arizona College of Pharmacy, Tucson, Arizona.
authors.forename: Heidi M
authors.initials: HM
authors.lastname: Mansour
authors.affiliation: Department of Surgery, The Ohio State University, Columbus, Ohio.
authors.forename: Sylvester M
authors.initials: SM
authors.lastname: Black
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D016040:Lung Transplantation / Q000401:mortality; D008875:Middle Aged; D066027:Transplant Recipients / Q000706:statistics & numerical data*; D055815:Young Adult