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Ann Thorac Surg 2006;82:1835-1841
© 2006 The Society of Thoracic Surgeons

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Original Articles: General Thoracic

Lung Transplantation in Patients 60 Years and Older: Results, Complications, and Outcomes

^a Department of Surgery, University of Virginia, Charlottesville, Virginia
^b Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia
^c Department of Internal Medicine, University of Virginia, Charlottesville, Virginia

Accepted for publication May 11, 2006.

^_* Address correspondence to Dr Jones, Department of Surgery, University of Virginia, PO Box 800679, Charlottesville, VA 22908-0679 (Email: djones{at}virginia.edu).

Presented at the Forty-second Annual Meeting of The Society of Thoracic Surgeons, Chicago, IL, Jan 30–Feb 2, 2006.

BACKGROUND: Advanced recipient age is reported to negatively affect survival after lung transplantation (LTX). We hypothesized that LTX in patients aged 60 years could be performed with acceptable outcomes.

METHODS: We identified 182 consecutive LTX recipients from 1995 to 2005. Outcomes were analyzed and survival compared with results in recipients aged <60, as well as with United Network for Organ Sharing (UNOS) registry outcomes for the same age and study period. Actuarial survivals were calculated by the Kaplan-Meier method.

RESULTS: During the study period, 29% (52/182) of LTX recipients were 60 years old (range, 60 to 69 years). Median follow-up was 2.9 years (range, 0 to 10 years). All patients but one received a single lung. Indications included chronic obstructive pulmonary disease in 63% (33/52), idiopathic pulmonary fibrosis in 27% (14/52), and other in 10% (5/52). In-hospital mortality was 12% (6/52) for those aged 60 compared with 7% (9/130) for those aged <60 (p = NS). Complications included reoperation in 10% (5/52), requirement for extracorporeal membrane oxygenation in 6% (3/52), renal failure in 12% (6/52), and stroke in 4% (2/52). Actuarial survivals at 30 days, and 1, 3, and 5 years were 90% (82, 98), 86% (76, 96), 71% (56, 85), and 55% (37, 73), respectively. No significant difference in survival was observed between age cohorts for our institutional data by Kaplan-Meier analysis (p = 0.34) or by Cox proportional hazard model (p = 0.15). A significant survival advantage was noted for our institution compared with UNOS for this cohort (p = 0.018).

CONCLUSIONS: In carefully selected recipients 60 years of age, LTX offers acceptable outcomes and survival.

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