Analysis of UNOS Database: Survival Outcome in Elderly Lung Transplant Recipients

Abstract

Purpose The number of elderly patients requiring a lung transplantation (LTx) continues to grow. However, there are concerns that the age distribution of LTx recipients may be unbalanced, at a detriment to elderly patients. In order to assess the relationship between LTx and recipient age, we investigated the survival outcomes of elderly primary single and double LTx patients through analysis of the UNOS database. Methods We analyzed the UNOS database (1987-2014), investigating single and double LTx recipients based on three separate age groups (≤69, 70-74, and ≥75 years old). Using variables such as age, gender, ethnicity, BMI, length of stay (LOS), ECMO, inhaled NO usage, blood group, and procedure type, the three groups were compared for any significance (p=0.05). Survival outcomes were compared between the groups (STATA Inc.) and data were presented as mean±standard deviation. Results During 1987 to 2014, 27,980 patients received LTx (n= 16,015 double LTx, and n=11,888 single LTx). Out of total LTx patients, 27,076 patients were ≤69, 729 patients were 70-74, and 98 patients were ≥75 years old. Demographic data showed 54% male, 86% white, 7% black, 5% Latino, and 2% other. Recipient mean age was 55±15 years, with BMI- 24±4 kg/m2, median LOS was 15 days, and blood groups: O-45%, A-40%, B-11%, AB-4%. UNOS showed lower data on ECMO-1% and inhaled NO-0.21% usage. Log-rank test for equality of survival demonstrated significance based on age for patients who received single and double LTx (p Conclusion Survival outcome of single LTx patients did not show any significant statistical difference when performed in elderly patients above 70 years of age. When double LTx were performed, younger patients below 69 years of age seemed to do better in survival compared to elderly patients above 70 years of age. The beneficial survival outcome for single LTx patients extends to an older age than double LTx patients.