Donors in lung transplantation: does age matter?
Fiche publication
Date publication
juillet 2023
Journal
Interdisciplinary cardiovascular and thoracic surgery
Auteurs
Membres identifiés du Cancéropôle Est :
Pr FALCOZ Pierre-Emmanuel, Pr OLLAND Anne
Tous les auteurs :
Ponte C, Alkhatiri O, Olland A, Falcoz PE
Lien Pubmed
Résumé
A best-evidence topic was written according to a structured protocol. The question addressed was the following: in patient undergoing lung transplantation (LTx), are lungs from donors of age > 60 years old (yo) associated with equivalent outcomes-including primary graft dysfunction (PGD), respiratory function and survival-than lungs from donors ≤60yo? Altogether, more than 200 papers were found using the reported search, of which 12 represented the best evidence to answer the clinical question. The authors, journals, dates, country of publication, patients group studied, study type, relevant outcomes, and results of these papers were tabulated. Amongst the 12 papers reviewed, survival results were different depending on whether donor age was analyzed raw or adjusted for recipients' age and initial diagnosis. Indeed, recipients with interstitial lung disease (ILD), pulmonary hypertension or cystic fibrosis (CF) had significantly inferior overall survival when receiving grafts from older donors. When older grafts are allocated to younger donors, a significant decrease in survival has been noticed in the case of single LTx. In addition, three papers showed worse results regarding peak forced expiratory volume in 1 second (FEV1) in patients receiving older organs, and four showed comparable PGD incidence rates. We conclude that when carefully assessed and allocated to the recipient who could benefit most from the transplant (e.g., a patient with a diagnosis of chronic obstructive pulmonary disease (COPD), who would not require a prolonged cardiopulmonary bypass (CPB)), lung grafts from donors of more than 60yo offer comparable results to younger donors.
Mots clés
donors > 60 years old, lung transplantation, outcomes, respiratory function, survival
Référence
Interdiscip Cardiovasc Thorac Surg. 2023 07 8;: