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Effect of Donor Age on Outcome of Lung Transplantation Stratified by Recipient Diagnosis : A Nordic Multicenter Study

Auråen, Henrik; Durheim, Michael Thomas; Dellgren, Göran; Hämmäinen, Pekka; Larsson, Hillevi LU ; Geiran, Odd; Schultz, Hans Henrik Lawaetz; Leuckfeld, Inga; Iversen, Martin and Fiane, Arnt, et al. (2019) In Transplantation 103(4). p.807-814
Abstract

BACKGROUND: Organs from older donors are increasingly used in lung transplantation, and studies have demonstrated that this could be safe in selected recipients. However, which recipient groups that have the largest benefit of older organs are unclear. This multicenter study reviews all bilateral lung transplantations (BLTx) from donors 55 years or older stratified by recipient diagnosis and compares outcomes with transplantations from younger donors. METHODS: All BLTx recipients (excluding retransplantation) at 5 Scandiatransplant centers between 2000 and 2013 were included (n = 913). Recipients were stratified to diagnosis groups including cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD), interstitial lung disease... (More)

BACKGROUND: Organs from older donors are increasingly used in lung transplantation, and studies have demonstrated that this could be safe in selected recipients. However, which recipient groups that have the largest benefit of older organs are unclear. This multicenter study reviews all bilateral lung transplantations (BLTx) from donors 55 years or older stratified by recipient diagnosis and compares outcomes with transplantations from younger donors. METHODS: All BLTx recipients (excluding retransplantation) at 5 Scandiatransplant centers between 2000 and 2013 were included (n = 913). Recipients were stratified to diagnosis groups including cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), and "other." Intensive care unit (ICU) length of stay (LOS) and survival were assessed. RESULTS: Overall, there was no difference in survival among patients transplanted from donors 55 years or older compared with younger donors. However, in CF recipients, donor age 55 years or older was associated with inferior survival (P = 0.014), and this remained significant in a multivariate model (hazard ratio, 5.0; 95% confidence interval, 1.8-14.1; P = 0.002). There was no significant effect of donor age on survival in recipients with COPD, ILD, or in the "other" group in multivariate models. Utilization of older donors was associated with increased ICU LOS for recipients with CF and ILD, but not in the COPD or "other" group. CONCLUSIONS: The BLTx recipients with CF had inferior survival and longer ICU LOS when receiving organs from donors 55 years or older. Recipients with COPD, ILD, or in the "other" group did not have inferior survival in multivariate models.

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published
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Transplantation
volume
103
issue
4
pages
8 pages
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:85063713084
ISSN
1534-6080
DOI
10.1097/TP.0000000000002402
language
English
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yes
id
d882d11a-9959-417f-8272-9c16ee48ee1f
date added to LUP
2019-04-09 14:02:32
date last changed
2019-05-08 02:30:22
@article{d882d11a-9959-417f-8272-9c16ee48ee1f,
  abstract     = {<p>BACKGROUND: Organs from older donors are increasingly used in lung transplantation, and studies have demonstrated that this could be safe in selected recipients. However, which recipient groups that have the largest benefit of older organs are unclear. This multicenter study reviews all bilateral lung transplantations (BLTx) from donors 55 years or older stratified by recipient diagnosis and compares outcomes with transplantations from younger donors. METHODS: All BLTx recipients (excluding retransplantation) at 5 Scandiatransplant centers between 2000 and 2013 were included (n = 913). Recipients were stratified to diagnosis groups including cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), and "other." Intensive care unit (ICU) length of stay (LOS) and survival were assessed. RESULTS: Overall, there was no difference in survival among patients transplanted from donors 55 years or older compared with younger donors. However, in CF recipients, donor age 55 years or older was associated with inferior survival (P = 0.014), and this remained significant in a multivariate model (hazard ratio, 5.0; 95% confidence interval, 1.8-14.1; P = 0.002). There was no significant effect of donor age on survival in recipients with COPD, ILD, or in the "other" group in multivariate models. Utilization of older donors was associated with increased ICU LOS for recipients with CF and ILD, but not in the COPD or "other" group. CONCLUSIONS: The BLTx recipients with CF had inferior survival and longer ICU LOS when receiving organs from donors 55 years or older. Recipients with COPD, ILD, or in the "other" group did not have inferior survival in multivariate models.</p>},
  author       = {Auråen, Henrik and Durheim, Michael Thomas and Dellgren, Göran and Hämmäinen, Pekka and Larsson, Hillevi and Geiran, Odd and Schultz, Hans Henrik Lawaetz and Leuckfeld, Inga and Iversen, Martin and Fiane, Arnt and Holm, Are Martin},
  issn         = {1534-6080},
  language     = {eng},
  number       = {4},
  pages        = {807--814},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Transplantation},
  title        = {Effect of Donor Age on Outcome of Lung Transplantation Stratified by Recipient Diagnosis : A Nordic Multicenter Study},
  url          = {http://dx.doi.org/10.1097/TP.0000000000002402},
  volume       = {103},
  year         = {2019},
}