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A single-center analysis of lung transplantation outcomes in recipients aged 70 or older

医学 倾向得分匹配 单中心 内科学 对数秩检验 肺移植 回顾性队列研究 外科 生存分析 移植
作者
Mohammed A. Kashem,Hannah Calvelli,Michael Warnick,Hiromu Kehara,Vipin Dulam,Huaqing Zhao,Roh Yanigada,Norihisa Shigemura,Yoshiya Toyoda
出处
期刊:European Journal of Cardio-Thoracic Surgery [Oxford University Press]
卷期号:65 (6)
标识
DOI:10.1093/ejcts/ezae150
摘要

Abstract OBJECTIVES As life expectancies continue to increase, a greater proportion of older patients will require lung transplants (LTs). However, there are no well-defined age cutoffs for which LT can be performed safely. At our high-volume LT centre, we explored outcomes for LT recipients ≥70 vs <70 years old. METHODS This is a retrospective single-centre study of survival after LT among older recipients. Data were stratified by recipient age (≥70 vs <70 years old) and procedure type (single versus double LT). Demographics and clinical variables were compared using Chi-square test and 2 sample t-test. Survival was assessed by Kaplan–Meier curves and compared by log-rank test with propensity score matching. RESULTS A total of 988 LTs were performed at our centre over 10 years, including 289 LTs in patients ≥70 years old and 699 LTs in patients <70 years old. The recipient groups differed significantly by race (P < 0.0001), sex (P = 0.003) and disease aetiology (P < 0.0001). Older patients were less likely to receive a double LT compared to younger patients (P < 0.0001) and had lower rates of intraoperative cardiopulmonary bypass (P = 0.019) and shorter length of stay (P = 0.001). Both groups had overall high 1-year survival (85.8% vs 89.1%, respectively). Survival did not differ between groups after propensity matching (P = 0.15). CONCLUSIONS Our data showed high survival for older and younger LT recipients. There were no statistically significant differences observed in survival between the groups after propensity matching, however, a trend in favour of younger patients was observed.

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