Outcome of Lung Transplantation Using Grafts From Donors Over 65 Years of Age

Renard, Régis; Girault, Antoine; Avramenko-Bouvier, Alla; Roussel, Arnaud; Cerceau, Pierre; Pellenc, Quentin; Bunel, Vincent; Godet, C.; Jébrak, G.; Messika, Jonathan; Mal, Hervé; Castier, Yves; Mordant, Pierre; Boudinet, Sandrine; Jean-Baptiste, Sylvain; Longrois, Dan; Lortat‐Jacob, Brice; Montravers, Philippe; Tran-Dinh, Alexy; Hammouda, Malika; Lefèvre, Lucie; Savary, Alice; Abadie, Agnès; Brouk, Zohra

doi:10.1016/j.athoracsur.2020.10.018

Cited by 17 publications

(17 citation statements)

References 31 publications

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“…The psychologist provides a regular follow-up if the patient requests it or if the psychologist believes the patient would benefit from such care. All other aspects of medical LT care are described elsewhere [18] .…”

Section: Methodsmentioning

confidence: 99%

Coping strategies, anxiety and depression related to the COVID-19 pandemic in lung transplant candidates and recipients. Results from a monocenter series

Savary

Hammouda

Genet

et al. 2021

Respiratory Medicine and Research

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Background The COVID-19 pandemic has been associated with an increase in anxiety and depression symptoms in people. We investigated the impact of the pandemic on coping strategies and anxiety and depression in lung transplantation (LT) recipients and patients with end-stage chronic lung disease awaiting LT. Methods We retrospectively investigated coping strategies by using the Coping Inventory for Stressful Situations questionnaire and anxiety and depression symptoms by the Hospital Anxiety and Depression scale in 115 LT candidates and recipients. Results Overall, 63 participants (20 women; median age 59 years [interquartile range 52-65]) answered one or both questionnaires (49 LT recipients and 14 LT candidates). The preferred coping strategy was task-focused for 51 (86.4%) participants, with no difference between LT recipients and candidates nor according to the main anamnestic and clinical data. Eleven patients had suspected or proven depression symptoms, and 18 had suspected or proven anxiety symptoms. Coping strategies related to COVID-19 did not differ by presence of anxiety or depression symptoms. Conclusion In the current pandemic, healthcare professionals should consider these results to provide relevant psychological help to these fragile populations and promote a systematic and wide multidisciplinary assessment of LT recipients and candidates.

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Section: Methodsmentioning

confidence: 99%

Coping strategies, anxiety and depression related to the COVID-19 pandemic in lung transplant candidates and recipients. Results from a monocenter series

Savary

Hammouda

Genet

et al. 2021

Respiratory Medicine and Research

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“…Usual management of LTx in our center is highly protocolized and reported elsewhere (11). In brief, intraoperative veno-arterial extracorporeal membrane oxygenation (ECMO) was initiated according to hemodynamics and respiratory findings during surgery (12), with peripheral cannulation.…”

Section: Ltx Managementmentioning

confidence: 99%

Risk of Bronchial Complications After Lung Transplantation With Respiratory Corynebacteria. Results From a Monocenter Retrospective Cohort Study

Sandot

Grall²,

Rodier³

et al. 2023

Transpl Int

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Corynebacterium spp. are associated with respiratory infections in immunocompromised hosts. A link with bronchial complications after lung transplantation (LTx) has been suggested. We aimed to assess the link between respiratory sampling of Corynebacterium spp. and significant bronchial complication (SBC) after LTx. We performed a single center retrospective study. Inclusion of LTx recipients with at least one respiratory Corynebacterium spp. sample (July 2014 to December 2018). Subjects were matched to unexposed LTx recipients. Primary outcome was SBC occurrence after Corynebacterium spp. isolation. Secondary outcomes were Corynebacterium spp. persistent sampling, chronic lung allograft dysfunction (CLAD) onset and all-cause mortality. Fifty-nine patients with Corynebacterium spp. sampling with 59 without isolation were included. Corynebacterium spp. identification was not associated with SBC occurrence (32.4% vs. 21.6%, p = 0.342). Previous SBC was associated with further isolation of Corynebacterium spp. (OR 3.94, 95% CI [1.72–9.05]). Previous SBC and corticosteroids pulses in the last 3 months were the only factors associated with increased risk of Corynebacterium spp. isolation in multivariate analysis. Corynebacterium spp. sampling was significantly associated with CLAD onset (27.1% vs. 6.9%, p = 0.021). Corynebacterium spp. isolation was not associated with SBC but with higher risk of CLAD. Whether CLAD evolution is affected by Corynebacterium spp. eradication remains to be investigated.

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“…[3][4][5] The donor age threshold of 60 years was chosen as a composite of sources citing marginality and increased mortality at anywhere from 50 to 70 years. [7][8][9][10] The significant smoking history threshold was chosen based on the UNOS database's categorical classification of donors as having either >20 or ≤20 packyear smoking history. Bronchoscopic and radiographic findings were considered marginal if the detected purulence or abnormalities was lateralized to at least one transplanted lung.…”

Section: Marginal Allograft Definitionsmentioning

confidence: 99%

Trends in marginal lung allograft survival: Advanced‐age donors improve

Miggins

Reul

Loor

et al. 2022

Clinical Transplantation

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Introduction Although lung demand continues to outpace supply, 75% of potential donor lungs are discarded without being transplanted in the United States. To identify the discarded cohorts best suited to alleviate the lung shortage and reduce waitlist mortality, we explored changes in survival over time for five marginal donor definitions: age >60 years, smoking history >20 pack‐years, PaO2/FiO2 < 300 mmHg, purulent bronchoscopic secretions, and chest radiograph infiltrates. Methods Our retrospective cohort study separated 27 803 lung recipients in the UNOS Database into three 5‐year eras by transplant date: 2005–2009, 2010–2014, and 2015–2019. Multivariable Cox proportional hazards regression and Kaplan‐Meier analysis with log‐rank test were used to compare survival across the eras. Results Three definitions—low PaO2/FiO2, purulent bronchoscopic secretions, and abnormal chest radiographs—did not bear out as truly marginal, demonstrating lack of significantly elevated risk. Advanced donor age demonstrated considerable survival improvement (HR (95% CI): 1.47 (1.26–1.72) in 2005–2009 down to 1.14 (.97–1.35) for 2015–2019), with protective factors being recipients <60 years, moderate recipient BMI, and low Lung Allocation Score (LAS). Donors with smoking history failed to demonstrate any significant improvement (HR (95% CI): 1.09 (1.01–1.17) in 2005–2009 increasing to 1.22 (1.08–1.38) in 2015–2019). Conclusions Advanced donor age, previously the most significant risk factor, has improved to near‐benchmark levels, demonstrating the possibility for matching older donors to healthier non‐elderly recipients in selected circumstances. Low PaO2/FiO2, bronchoscopic secretions, and abnormal radiographs demonstrated survival on par with standard donors. Significant donor smoking history, a moderate risk factor, has failed to improve.

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Outcome of Lung Transplantation Using Grafts From Donors Over 65 Years of Age

Cited by 17 publications

References 31 publications

Coping strategies, anxiety and depression related to the COVID-19 pandemic in lung transplant candidates and recipients. Results from a monocenter series

Coping strategies, anxiety and depression related to the COVID-19 pandemic in lung transplant candidates and recipients. Results from a monocenter series

Risk of Bronchial Complications After Lung Transplantation With Respiratory Corynebacteria. Results From a Monocenter Retrospective Cohort Study

Trends in marginal lung allograft survival: Advanced‐age donors improve

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