2. Older Donors: An Analysis of Survival in Elderly Recipients

J Surg Res 214, 109-116. 2017 Mar 06.

J Katsnelson et al.

BACKGROUND:

The average ages of lung transplant (LTx) recipients and donors are increasing. With older recipients considered to be especially at high risk of post-transplant mortality, we sought to determine whether the use of allografts from older donors affects survival among older

METHODS:

The United Network for Organ Sharing registry was used to identify patients aged 65-80 y receiving a first-time LTx between 1987 and 2013. Survival analysis examined implications of a donor-recipient age difference >10 y using Cox proportional hazards regression.

RESULTS:

The cohort selected for analysis included 3227 elderly LTx recipients, of whom 263 (8.15%) had donors within 10 y of their age at transplantation. Univariate Cox models found no differences with LTx involving donors at least 10 y younger than the recipient with respect to overall survival (hazard ratio = 0.979; 95% confidence interval [CI] = 0.807-1.188; P = 0.831) or conditional survival past 1 y (hazard ratio = 1.067; 95% CI = 0.819-1.391; P = 0.629) relative to LTx involving donors within 10 y of an elderly recipient’s age. These findings were substantiated in multivariate analysis adjusting for potential confounders.

CONCLUSIONS:

In elderly LTx recipients aged 65-80 y at transplantation, intermediate-term survival was not influenced by donor age. For the viable elderly LTx candidate, a carefully selected older donor should be considered to increase donor availability.