Predictive value of donor age for recipient lung function and CLAD-free survival after lung transplantation

Abstract

Introduction: One option to increase the number of organs for lung transplantation (LuTx) is to use lungs from older donors, and recipient survival disadvantage for donors >55 years has not been shown. This study aims to elucidate the effects of donor age on recipient lung function, chronic lung allograft dysfunction (CLAD) and survival. Methods: Donor age and recipient data for all double lung transplantations (DLTx) in Norway between 1990 and 2013 were assessed. Results: Data were available for 303 out of 306 DLTx. Mean donor age was 41.9 years (SD: 15.3, Range: 9-69). There was a sig. correlation between donor and recipient age (r=.27, p 55 years to younger donors. However, we found an inverse correlation between donor age and lung function (FEV1%, DLCO%, 6MWT) at 2 years post LuTx, and comparing CLAD vs. non-CLAD, donor age was sig. higher in recipients with CLAD at 2-year (50 vs 40, p=0.01) follow-up while recipient age was similar. The survival was lower in recipients with organs from donors aged 40-54 years (figure 1) compared to both older and younger donors. Conclusion: Recipient lung function at two years post LuTx inversely correlated with donor age, and recipients with donors aged 40-54 had reduced survival. Whether this was due to donor factors or recipient selection should be determined in larger studies.