Dahlman S, Jeppsson A, Scherstén H, Nilsson F
Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Transplant Proc. 2006 Oct;38(8):2691-3. doi: 10.1016/j.transproceed.2006.07.037.
The scarcity of donor organs is one of the major limitations to lung transplantation. This has led to a progressive expansion of criteria for donor selection in lung transplantation. This study evaluated the outcome of recipients of lungs from donors >/=55 years. We performed a retrospective analysis of 212 consecutive lung transplantations. Recipients were divided into two groups, those receiving lungs from donors >/=55 years (older donor group) and those receiving lungs from donors <55 years (younger donor group). Recipient baseline characteristics, time in the intensive care unit (ICU), early mortality, and long-term survival (Kaplan-Meier) were compared between the groups. Forty-one donors (19%) were >/=55 years. Mean recipient age in the older donor group was higher than in the younger donor group (52 +/- 8 vs. 47 +/- 12 years; P = .015). Indication for transplantation did not differ between the groups. ICU stay was comparable between the two groups (6 +/- 12 vs. 7 +/- 11 days; P = .64). Actual 30-day mortality (10.8% vs. 6.4%; P = .32), 1-year mortality (17.1 vs. 19.6%; P = .50), and cumulative long-term survival (65% and 62% at 5 years, P = 1.00) did not differ between the older and younger donor group. This study indicated that transplantation of lungs from selected donors aged >/=55 years did not impair short-or long-term results. The use of lungs from elderly donors may help to increase the number of donor organs for lung transplantation.
供体器官的稀缺是肺移植的主要限制因素之一。这导致了肺移植供体选择标准的逐步扩大。本研究评估了接受年龄≥55岁供体肺的受者的结局。我们对212例连续肺移植进行了回顾性分析。受者被分为两组,一组接受年龄≥55岁供体的肺(老年供体组),另一组接受年龄<55岁供体的肺(年轻供体组)。比较两组受者的基线特征、重症监护病房(ICU)住院时间、早期死亡率和长期生存率(Kaplan-Meier法)。41名供体(19%)年龄≥55岁。老年供体组受者的平均年龄高于年轻供体组(52±8岁 vs. 47±12岁;P = 0.015)。两组间移植指征无差异。两组的ICU住院时间相当(6±12天 vs. 7±11天;P = 0.64)。老年供体组和年轻供体组的实际30天死亡率(10.8% vs. 6.4%;P = 0.32)、1年死亡率(17.1% vs. 19.6%;P = 0.50)和累积长期生存率(5年时分别为65%和62%,P = 1.00)无差异。本研究表明,移植年龄≥55岁的选定供体的肺不会损害短期或长期结果。使用老年供体的肺可能有助于增加肺移植供体器官的数量。