Purpose: In 2014, The International Society for Heart and Lung Transplantation published consensus guidelines listing age greater than 65 years as a relative contraindication to lung transplant due to reduced physiologic reserve and presence of comorbidities that may lead to poorer outcomes. The purpose of this study is to assess clinical outcomes and post-transplant complications among elderly lung transplant recipients (LTR) as compared to younger cohorts at our institution.

Methods: This is a single center, retrospective, cohort study. Eligible patients received a single or double lung transplant between January 1, 2012 and December 31, 2014 and were 50 years or older at the time of transplant. Patients who received a redo lung or multi-organ transplant, or expired prior to discharge were excluded. The primary endpoint is number of days alive and outside a healthcare facility in the first year post-transplant.

Results: Two-hundred thirty-seven patients met eligibility criteria as follows: 50-59 years (n=68); 60-69 years (n=105); and greater than 70 years (n=64). The two older cohorts had a greater percentage of males (54.5% vs. 71.4% vs. 71.9%; p=0.04) and Caucasians (66.2% vs. 72.3% vs. 89.1%; p=0.01) compared to the youngest cohort. Lung allocation scores were similar among the cohorts (42.7±16.2 vs. 43.8±17.9 vs. 45.0±16.0; p=0.73); however, more patients in the two older cohorts received a single lung transplant (30.9% vs. 56.2% vs. 78.1%; p<0.01). Preliminary results suggest no difference in total days alive and outside a healthcare facility in the first year post-transplant (289.4±98.9 vs. 268.5±110.4 vs. 270.6±112.9 days; p=0.43), 1-year patient survival (91.2% vs. 83.0% vs. 81.3%; p=0.22), or total hospitalized days in the first year post-transplant (16.2±22.9 vs. 21.8±26.8 vs. 19.6±22.7 days; p=0.34). Furthermore, post-transplant length of stay (LOS) (16.3±8.7 vs. 18.6±12.2 vs. 15.2±8.8 days; p=0.10) and intensive care unit LOS (7.3±8.4 vs. 9.9±11.1 vs. 7.0±8.8 days; p=0.10) during the index admission were similar among the cohorts. A greater percentage of patients ages 60-69 years were discharged to long-term acute care facilities after the index admission (29.4% vs. 51.4% vs. 40.6%; p=0.02).

Conclusion: Preliminary data suggests outcomes in elderly LTR in the first year post-transplant may be similar to their younger counterparts.

CITATION INFORMATION: Casciello N, Fuentes A, Krisl J, Sinha N, Kaleekal T. Hospitalizations, Survival, and Complications: 1-Year Outcomes for Elderly Lung Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).

« Back to 2016 American Transplant Congress