The outcome of lung transplantation (LT) is correlated to donor selection. A donor age65 years is classically considered a contra-indication to lung procurement, and the results of LT from elderly donors remain to be established.
We set a retrospective study of a prospectively maintained database including all LT performed in our institution from January 2014 to March 2019. Donors65 years were included in the elderly group while donors<65 years were included in the control group.
The study group included 241 LT, including 44 (18%) in the elderly group and 197 (82%) in the control group. As compared with the control group, the elderly group was characterized by donor with smaller size (166cm vs. 172cm, p=0.04), less smoking history (14% vs. 40%, p=0.001), less bronchoscopic abnormality (20% vs. 36%, p=0.042), and less chest opacity (16% vs. 30%, p=0.048); by recipients with smaller size (166cm vs. 170cm, p=0.04) but similar diagnoses and gravity. There was no significant difference between groups in any of the outcomes studied, including Primary Graft dysfunction, 30-day mortality, one-year survival, clad-free survival, and overall survival. In univariate analysis, Oto lung donor score was the only factor associated with one-year survival (6 in alive patients vs. 7 in dead patients, p=0.04), donor age 65 years was not.
Carefully selected lung grafts from donors65 years are associated with similar outcomes than grafts from younger donors, thus being an interesting option to expand the donor pool in a shortage period.

Copyright © 2020. Published by Elsevier Inc.

References

PubMed