Outcomes after lung transplantation from selected donors older than 70 years in a single centre : time to close the debate?
© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved..
OBJECTIVES: The aim of this study was to compare the outcomes of lung transplantations using grafts from donors aged over 70 years against those performed using younger donors.
METHODS: This retrospective single-centre analysis includes lung transplants conducted at our institution from January 2014 to June 2022. Lung recipients were classified into 2 groups based on donor age (group A <70 years; group B ≥70 years). Variables regarding demographics, peri and postoperative outcomes and survival were included. The statistical analysis approach included univariable analysis, propensity score matching to address imbalances in donor variables (smoking status), recipient characteristics (sex, age, diagnosis and lung allocation score) and calendar period and survival analysis.
RESULTS: A total of 353 lung transplants were performed in this period, 47 (13.3%) using grafts from donors aged over 70 years. Donors in group B were more frequently women (70.2% vs 51.6%, P = 0.017), with less smoking history (22% vs 43%, P = 0.002) and longer mechanical ventilation time (3 vs 2 days, P = 0.025). Recipients in group B had a higher lung allocation score (37.5 vs 35, P = 0.035). Postoperative variables were comparable between both groups, except for pulmonary function tests. Group B demonstrated lower forced expiratory volume 1 s levels (2070 vs 2580 ml, P = 0.001). The propensity score matching showed a lower chance of chronic lung allograft dysfunction by 12% for group B. One-, three- and five-year survival was equal between the groups.
CONCLUSIONS: The use of selected expanded-criteria donors aged over 70 years did not result in increased postoperative morbidity, early mortality or survival in this study.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:65 |
|---|---|
| Enthalten in: |
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery - 65(2024), 3 vom: 01. März |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Romero Román, Alejandra [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Chronic lung allograft dysfunction |
|---|
| Anmerkungen: |
Date Completed 22.03.2024 Date Revised 22.03.2024 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1093/ejcts/ezae077 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM369294238 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM369294238 | ||
| 003 | DE-627 | ||
| 005 | 20240323001019.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240305s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/ejcts/ezae077 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1341.xml |
| 035 | |a (DE-627)NLM369294238 | ||
| 035 | |a (NLM)38439563 | ||
| 035 | |a (PII)ezae077 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Romero Román, Alejandra |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Outcomes after lung transplantation from selected donors older than 70 years in a single centre |b time to close the debate? |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 22.03.2024 | ||
| 500 | |a Date Revised 22.03.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. | ||
| 520 | |a OBJECTIVES: The aim of this study was to compare the outcomes of lung transplantations using grafts from donors aged over 70 years against those performed using younger donors | ||
| 520 | |a METHODS: This retrospective single-centre analysis includes lung transplants conducted at our institution from January 2014 to June 2022. Lung recipients were classified into 2 groups based on donor age (group A <70 years; group B ≥70 years). Variables regarding demographics, peri and postoperative outcomes and survival were included. The statistical analysis approach included univariable analysis, propensity score matching to address imbalances in donor variables (smoking status), recipient characteristics (sex, age, diagnosis and lung allocation score) and calendar period and survival analysis | ||
| 520 | |a RESULTS: A total of 353 lung transplants were performed in this period, 47 (13.3%) using grafts from donors aged over 70 years. Donors in group B were more frequently women (70.2% vs 51.6%, P = 0.017), with less smoking history (22% vs 43%, P = 0.002) and longer mechanical ventilation time (3 vs 2 days, P = 0.025). Recipients in group B had a higher lung allocation score (37.5 vs 35, P = 0.035). Postoperative variables were comparable between both groups, except for pulmonary function tests. Group B demonstrated lower forced expiratory volume 1 s levels (2070 vs 2580 ml, P = 0.001). The propensity score matching showed a lower chance of chronic lung allograft dysfunction by 12% for group B. One-, three- and five-year survival was equal between the groups | ||
| 520 | |a CONCLUSIONS: The use of selected expanded-criteria donors aged over 70 years did not result in increased postoperative morbidity, early mortality or survival in this study | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Chronic lung allograft dysfunction | |
| 650 | 4 | |a Extended criteria donors | |
| 650 | 4 | |a Extracorporeal life support | |
| 650 | 4 | |a Lung transplantation | |
| 650 | 4 | |a Older donors | |
| 700 | 1 | |a Gil Barturen, Mariana |e verfasserin |4 aut | |
| 700 | 1 | |a Crowley Carrasco, Silvana |e verfasserin |4 aut | |
| 700 | 1 | |a Hoyos Mejía, Lucas |e verfasserin |4 aut | |
| 700 | 1 | |a Naranjo Gómez, Jose Manuel |e verfasserin |4 aut | |
| 700 | 1 | |a Córdoba Peláez, Mar |e verfasserin |4 aut | |
| 700 | 1 | |a Pérez Redondo, Marina |e verfasserin |4 aut | |
| 700 | 1 | |a Royuela Vicente, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a García Fadul, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Gómez de Antonio, David |e verfasserin |4 aut | |
| 700 | 1 | |a Novoa, Nuria María |e verfasserin |4 aut | |
| 700 | 1 | |a Campo-Cañaveral de la Cruz, Jose Luis |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery |d 1996 |g 65(2024), 3 vom: 01. März |w (DE-627)NLM012606200 |x 1873-734X |7 nnns |
| 773 | 1 | 8 | |g volume:65 |g year:2024 |g number:3 |g day:01 |g month:03 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/ejcts/ezae077 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 65 |j 2024 |e 3 |b 01 |c 03 | ||