Sam Bastani1, Rajan Saggar2, Ramin Beygui1, David J. Ross2, Joseph P. Lynch2, Gabriel T. Schnickel1, Abbas Ardehali1; 1Division of Cardiac Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA; 2Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA
Objective: Age 65 and older is generally considered a contraindication to lung transplantation. Our group has offered lung transplantation to select patients 65 years of age and older who lack other co-morbid conditions. We sought to define the short and medium term survival of patients aged 65 and older who underwent lung transplantation.Methods: We reviewed the records of our transplant recipients from July 1999 through September 2006. The demographics, peri-operative characteristics, and survival of patients aged 65 and older (older group) were compared to those under 65 years of age (standard group).
Results: Comparisons made between the older and standard group are available for reference in Table 1. The causes of death in the older group between 1 month and 1 year post-transplant were: infections (75%), myocardial infarction (12.5%), and BOS (12.5%).
Conclusion: The 1 month and 3-year survival of patients 65 years of age and older undergoing lung transplantation is similar to the younger group. The increased mortality of older patients between 1-month and 1-year post-transplant, predominantly from infectious causes, may be due to immunosenescence of older patients. This finding warrants adjustments in the immunosuppression protocol of older patients undergoing lung transplantation. Lung transplantation could be offered to select older patients with adjustments in immunosuppression management. The impact of such policy on donor lung availability deserves further investigation.
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