Service de Chirurgie Thoracique et Transplantation Pulmonaire, Hôpital Foch, Suresnes, France.
Service de Pneumologie, Hopital Foch, Suresnes, France.
Transpl Int. 2023 Jun 12;36:11180. doi: 10.3389/ti.2023.11180. eCollection 2023.
Lung transplantation is limited by the shortage of suitable donors. Many programs have begun to use extended criteria donors. Donors over 65 years old are rarely reported, especially for young cystic fibrosis recipients. This monocentric study was conducted for cystic fibrosis recipients from January 2005 to December 2019, comparing two cohorts according to lung donor age (<65 years or ≥65 years). The primary objective was to assess the survival rate at 3 years using a Cox multivariable model. Of the 356 lung recipients, 326 had donors under 65 years, and 30 had donors over 65 years. Donors' characteristics did not differ significantly in terms of sex, time on mechanical ventilation before retrieval, and partial pressure of arterial oxygen/fraction of inspired oxygen ratio. There were no significant differences in post-operative mechanical ventilation duration and incidence of grade 3 primary graft dysfunction between the two groups. At 1, 3, and 5 years, the percentage of predicted forced expiratory volume in 1 s ( = 0.767) and survival rate did not differ between groups ( = 0.924). The use of lungs from donors over 65 years for cystic fibrosis recipients allows extension of the donor pool without compromising results. Longer follow-up is needed to assess the long-term effects of this practice.
肺移植受到合适供体短缺的限制。许多项目已经开始使用扩展标准供体。很少有报道超过 65 岁的供体，特别是对于年轻的囊性纤维化受者。本单中心研究于 2005 年 1 月至 2019 年 12 月对囊性纤维化受者进行，根据供体年龄（<65 岁或≥65 岁）将两个队列进行比较。主要目的是使用 Cox 多变量模型评估 3 年生存率。在 356 例肺移植受者中，326 例供体年龄<65 岁，30 例供体年龄≥65 岁。供体的性别、在检索前使用机械通气的时间和动脉血氧分压/吸入氧分数比在两组间无显著差异。两组术后机械通气时间和 3 级原发性移植物功能障碍发生率无显著差异。在 1、3 和 5 年时，预计 1 秒用力呼气量的百分比（=0.767）和生存率在两组间无差异（=0.924）。对于囊性纤维化受者，使用年龄超过 65 岁的供体可以扩大供体库，而不会影响结果。需要更长的随访时间来评估这种做法的长期影响。
