EFFECT OF DONOR AGE ON OUTCOME OF LUNG TRANSPLANTATION STRATIFIED BY RECIPIENT DIAGNOSIS: A NORDIC MULTICENTER STUDY

Background Organs from older donors are increasingly used in lung transplantation, and studies have demonstrated that this could be safe in selected recipients. However, which recipient groups that have the largest benefit of older organs are unclear. This multicenter study reviews all bilateral lung transplantations (BLTx) from donors ≥55 years stratified by recipient diagnosis, and compares outcomes with transplantations from younger donors. Methods All BLTx recipients (excluding ReTx) at 5 Scandiatransplant centers between 2000 and 2013 were included (n=913). Recipients were stratified to diagnosis groups including cystic fibrosis (CF), Chronic Obstructive Pulmonary Disease (COPD), interstitial lung disease (ILD) and "Other". Intensive care unit (ICU) length of stay (LOS) and survival were assessed. Results Overall, there was no difference in survival among patients transplanted from donors ≥ 55 years compared to younger donors. However, in CF-recipients, donor age ≥55 years was associated with inferior survival (p=0.014), and this remained significant in a multivariate model (HR 5.0, CI 1.8 – 14.1, p=0.002). There was no significant effect of donor age on survival in recipients with COPD, ILD or in the "Other"-group in multivariate models. Utilization of older donors was associated with increased ICU LOS for recipients with CF and ILD, but not in the COPD or "Other"-group. Conclusions BLTx recipients with CF had inferior survival and longer ICU LOS when receiving organs from donors ≥55 years. Recipients with COPD, ILD or in the "Other"-group did not have inferior survival in multivariate models. Authorship information Author-Areas of participation Auråen H-Research design, writing, performance of research, data analysis Durheim MT-Research design, writing, performance of research, data analysis Dellgren G-Writing, performance of research Hämmäinen P-Writing, performance of research Larsson H-Writing, performance of research Geiran O-Writing, performance of research Lawaetz Schultz HH-Writing, performance of research Leuckfeld I-Writing, performance of research Iversen M-Writing, performance of research Fiane AE-Writing, performance of research Holm AM-Research design, writing, performance of research, data analysis Conflict of interest statement: The authors declare no conflicts of interest. Funding: First author Auråen H received funding from The Norwegian Respiratory Society to conduct this research. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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