Older donor lungs should be considered for transplantation

November 09, 2017

Chicago, Nov. 9, 2017 - With a scarcity of lungs available for transplantation, the use of lungs from donors older than age 60 has been shown to achieve reasonable outcomes and should be considered as a viable option, according to research published online today in The Annals of Thoracic Surgery.

"The availability of suitable donor lungs for transplantation continues to be a major obstacle to increasing the number of lung transplants performed annually," said William Whited, MD, of the University of Louisville in Kentucky. "Research such as this that explores the means of expanding the donor pool is of critical importance."

Dr. Whited, along with senior author Matthew Fox, MD, and other colleagues from the University of Louisville queried the United Network of Organ Sharing (UNOS) thoracic transplant database to identify lung transplant recipients age 18 years or older. Between January 2005 and June 2014, 14,222 lung transplants were performed. Of these lung transplant recipients, 26% were age 50 years or younger, with 2% receiving lungs from donors older than age 60. Among this group of younger patients who received older donor lungs, there was no significant difference in 5-year survival when compared to patients who received lungs from younger donors.

The researchers also examined the impact of double versus single lung transplant on long-term survival, finding that younger patients who received older donor lungs experienced much better outcomes when a double versus a single transplantation was performed. The study showed that in younger patients who received a single lung transplant using organs from older vs. younger donors, there was a lower 5-year survival (15% vs. 50%). However, with a double lung transplant, there was no significant difference in 5-year survival (53% vs. 59%).

"This study demonstrated that reasonable outcomes are possible with the use of advanced age donors," said Dr. Whited.

"Ideal donor" criteria vary by hospital, but the researchers said that the criteria generally consist of brain death, age less than 45 to 50 years, minimal smoking history, and no evidence of pneumonia or trauma. Donor organs that do not meet all of the ideal donor criteria are sometimes accepted, but not always. Dr. Whited explained that while the use of extended criteria donor lungs varies from program to program, most surgeons should be willing to accept non-ideal donors, especially those who are older but otherwise good candidates.

"The vast majority of potential donors do not meet the relatively strict donor criteria," said Dr. Whited. "As a result, we need to continue exploring options that would expand the donor pool and more aggressively utilize extended criteria donors. Much like the general population, the donor pool has continued to grow older. Now more than ever, we have to rely on older donors."

The U.S. Organ Procurement & Transplant Network (OPTN) reports that 1,399 people currently are waiting for a lung transplant in the United States. The overall median waiting time for candidates on the wait list is 4 months, while more than 200 people die annually waiting for a lung transplant, according to an OPTN report.
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Notes for editors

The article is "Does Donor Age and Double Versus Single Lung Transplantation Affect Survival of Young Recipients? ," by W.M. Whited, P. Henley, E.M. Schumer, J.R. Trivedi, V.H. van Berkel, and M.P. Fox. It appears in The Annals of Thoracic Surgery published by Elsevier.

Find comprehensive medical information presented for patients by leading experts in cardiothoracic surgery at the STS Patient Website.

Copies of this paper are available to credentialed journalists upon request; please contact Jennifer Bagley at +1 312-202-5865 or jbagley@sts.org.

About The Annals of Thoracic Surgery

The Annals of Thoracic Surgery is the official journal of The Society of Thoracic Surgeons (STS) and the Southern Thoracic Surgical Association. It has an impact factor of 3.700. Founded in 1964, STS is a not-for-profit organization representing more than 7,300 cardiothoracic surgeons, researchers, and allied health care professionals worldwide who are dedicated to ensuring the best possible outcomes for surgeries of the heart, lung, and esophagus, as well as other surgical procedures within the chest. The Society's mission is to enhance the ability of cardiothoracic surgeons to provide the highest quality patient care through education, research, and advocacy.

About Elsevier

Elsevier is a global information analytics business that helps institutions and professionals progress science, advance healthcare and improve performance for the benefit of humanity. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, more than 35,000 e-book titles and many iconic reference works, including Gray's Anatomy. Elsevier is part of RELX Group, a global provider of information and analytics for professionals and business customers across industries. http://www.elsevier.com

Media contact

Jennifer Bagley
Society of Thoracic Surgeons
1-312-202-5865
jbagley@sts.org

Elsevier

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