Survival and spirometry outcomes after lung transplantation from donors aged 70 years and older

Sommer, W.; Ius, F.; Salman, J.; Avşar, M.; Tudorache, I.; Kühn, Christian; Wiegmann, Bettina; Marsch, Georg; Kaufeld, Tim; Zinne, Norman; Fuehner, Thomas; Greer, Mark; Gottlieb, Jens; Boethig, Dietmar; Haverich, Axel; Welte, Tobias; Warnecke, G.

doi:10.1016/j.healun.2015.06.002

Cited by 47 publications

(37 citation statements)

References 29 publications

(31 reference statements)

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“…Young donors typically provide a physiologically healthier and functionally more competent organ [15]. Although older age is not a contraindication for donation [16], the rate of intraoperative ECMO weaning was higher in cases with a young donor. The age cutoff value obtained by the receiver-operating characteristics curve was 45 years, and the ECMO weaning success rate for donors aged 45 years or less was 72.2% compared with 42.1% for donors aged more than 45 years (p ¼ 0.009).…”

Section: Commentmentioning

confidence: 99%

Risk Factor Analysis for Intraoperative Extracorporeal Membrane Oxygenation Weaning Failure After Lung Transplantation

Narm

Suh

Kim

et al. 2018

The Annals of Thoracic Surgery

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Section: Commentmentioning

confidence: 99%

Risk Factor Analysis for Intraoperative Extracorporeal Membrane Oxygenation Weaning Failure After Lung Transplantation

Narm

Suh

Kim

et al. 2018

The Annals of Thoracic Surgery

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“…No clear upper age limit of donor suitability exists and while evidence that increasing age influences longer term outcomes, 17 donors older with good exercise tolerance and low smoking history may lead to equivalent outcomes. 18 In theory, good oxygenation is an important indicator of functional quality of lung as measured by the PF ratio. However, it remains unclear how low it can be without affecting outcomes as recent analyses suggest this variable has less clinical relevance than has been previously stated.…”

Section: Standard Donor Quality Issues/limitationsmentioning

confidence: 99%

Donation after Brain Death versus Donation after Circulatory Death: Lung Donor Management Issues

Snell

Levvey

Levin

et al. 2018

Semin Respir Crit Care Med

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Lung transplantation (LTx) has traditionally been limited by a lack of suitable donor lungs. With the recognition that lungs are more robust than initially thought, the size of the donor pool of available lungs has increased dramatically in the past decade. Donation after brain death (DBD) and donation after circulatory death (DCD) lungs, both ideal and extended are now routinely utilized. DBD lungs can be damaged. There are important differences in the public's understanding, legal and consent processes, intensive care unit strategies, lung pathophysiology, logistics, and potential-to-actual donor conversion rates between DBD and DCD. Notwithstanding, the short- and long-term outcomes of LTx from any of these DBD versus DCD donor scenarios are now similar, robust, and continue to improve. Large audits suggest there remains a large untapped pool of DCD (but not DBD) lungs that may yet further dramatically increase lung transplant numbers. Donor scoring systems that might predict the donor conversion rates and lung quality, the role of ex vivo lung perfusion as an assessment and lung resuscitation tool, as well as the potential of donor lung quality biomarkers all have immense promise for the clinical field.

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“…8 A single center study has suggested similar one year mortality with donors >70 years old, although larger cohort studies have found increased mortality with donors older than 65 years, suggesting that utilization of very old donors carries additional risk. 8,9 There are also some combinations of donor and recipient age that may decrease post-transplantation survival. For example, a recent retrospective review found that the use of donors >50 increased the adjusted risk of death for recipients <60 but not those 60 and above.…”

Section: Donor Evaluationmentioning

confidence: 99%

Evaluation and Management of the Potential Lung Donor

Courtwright

Cantu

2017

Clinics in Chest Medicine

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SYNOPSIS The expansion of the donor lung pool has involved an evidence-driven redefinition of acceptable donors. Proceeding with transplantation with an acceptable rather than ideal donor depends on specific patient and organ-related risk factor as well as the severity of recipient illness. Although the physiological optimization of brain dead donors has not changed significantly in recent years, the use of donor management protocols has improved procurement rates. Ex vivo lung perfusion is an increasingly viable strategy to recondition lungs that would otherwise fall below the acceptable threshold for transplant. Ex vivo perfusion trials for preservation of standard donor lungs are ongoing.

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Survival and spirometry outcomes after lung transplantation from donors aged 70 years and older

Cited by 47 publications

References 29 publications

Risk Factor Analysis for Intraoperative Extracorporeal Membrane Oxygenation Weaning Failure After Lung Transplantation

Risk Factor Analysis for Intraoperative Extracorporeal Membrane Oxygenation Weaning Failure After Lung Transplantation

Donation after Brain Death versus Donation after Circulatory Death: Lung Donor Management Issues

Evaluation and Management of the Potential Lung Donor

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