OUTCOME FOLLOWING SINGLE VS. BILATERAL LUNG TRANSPLANTATION IN RECIPIENTS 60 YEARS OF AGE AND OLDER

Abstract

P651 Aims: The significant shortage of donor organs in lung transplantation (LTx) necessitates a careful selection of lung recipients. The outcome of lung transplant recipients aged 60 years and older has not been analyzed systematically. Methods: We retrospectively reviewed our experience with older recipients. Between 01/1999 and 07/2003, 248 patients (pts) underwent lung transplantation at our institution out of which 18 recipients (7.3%) were aged 60 years and older (range 60-66, mean 62±1.1 yrs). Results: N=11 pts (61%) out of the recipients 60 years and older received a single (SLTx) and n= 7 pts (39%) a bilateral (DLTx) lung transplant. Donor age in the SLTx cohort was 30±4 years (range 17-52 yrs) and 33±3 yrs (range18-53 yrs) in DLTx patients (p=0.1). Indications for LTx in the SLTx and the DLTx group was emphysema (n=6 vs n=3), fibrosis (n=4 vs n=3), and others (n=1 vs n=1), respectively, NS. Posttransplant ventilation time was significantly different among groups with 282±32.3 hours (hrs) after DLTx vs 56±12.8 hrs after SLTx (p<0.05). Also, the length of the post-LTx stay on the intensive care unit (ICU) was different in groups with 14±2.1 days (DLTx) vs. 4±1.3 days (SLTx); p<0.01. However, the first pO2 on post-LTx ICU arrival in the SLTx group was 317±42.8 mmHg vs. 282±45.9 mmHg in DLTx pts, which did not reach statistical significance. The 1-year survival, however, was statistically different between SLTx and DLTx recipients aged 60 yrs and older with 73% and 43%, respectively (p<0.05). The 1-year survival for the 18 recipients over 60 years was 61% vs. 82% for the other 230 patients younger than 60 years (p>0.05). Conclusions: The 1-year-survival following LTx (DLTx + SLTx) in patients older 60 years is markedly reduced compared to patients under 60 years of age. If a lung transplant is considered on a recipient > 60 years a SLTx should be favourised. If a SLTx is not indicated, patients > 60 years should be very carefully selected for DLTx.