Effect of donor age on short-term survival of patients with idiopathic pulmonary fibrosis after lung transplantation

Wang Jing; Hu Chunlan; Yu Huizhi; Li Xiaoshan; Xu Bo; Huang Dongxiao; Hu Chunxiao; Chen Jingyu

doi:10.3969/j.issn.1674-7445.2023.03.014

Volume 14 Issue 3

May 2023

Turn off MathJax

Article Contents

Article Navigation > ORGAN TRANSPLANTATION > 2023 > 14(3): 420-426

Wang Jing, Hu Chunlan, Yu Huizhi, et al. Effect of donor age on short-term survival of patients with idiopathic pulmonary fibrosis after lung transplantation[J]. ORGAN TRANSPLANTATION, 2023, 14(3): 420-426. doi: 10.3969/j.issn.1674-7445.2023.03.014

Citation:

PDF( 1468 KB)

Effect of donor age on short-term survival of patients with idiopathic pulmonary fibrosis after lung transplantation

doi: 10.3969/j.issn.1674-7445.2023.03.014

Department of Anesthesiology, the Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China

More Information

Corresponding author: Hu Chunxiao, Email: huchunxiao91211@163.com
Received Date: 2023-01-22
Publish Date: 2023-05-15

Abstract

Abstract

Objective To evaluate the effect of donor age on short-term survival of patients with idiopathic pulmonary fibrosis (IPF) after lung transplantation. Methods Clinical data of 235 IPF donors and recipients of lung transplantation were retrospectively analyzed. Univariate and multivariate Cox proportional hazard regression models were employed to analyze the correlation between donor age and short-term mortality rate of IPF patients after lung transplantation. Kaplan-Meier was used to draw the survival curve. Results Univariate Cox regression analysis showed that donor age was correlated with the 1-year fatality of IPF patients after lung transplantation. The 1-year fatality of recipients after lung transplantation was increased by 0.020 times if donor age was increased by 1 year (P=0.009). Oxygenation index of the donors, preoperative oxygenation index, preoperative lung allocation score, preoperative N-terminal pro brain natriuretic peptide, pattern of transplantation, pattern of intraoperative extracorporeal membrane oxygenation and intraoperative blood transfusion volume of the recipients were correlated with 1-year fatality after lung transplantation (all P < 0.1). Multivariate Cox regression analysis demonstrated that there was no correlation between donor age and 30-, 90-, 180-d and 1-year fatality of IPF patients after lung transplantation (all P > 0.05). Sensitivity analysis showed that there was no significant difference in 30-, 90-, 180-d and 1-year fatality after lung transplantation among donors aged < 18, 18-33, 34-49 and ≥50 years (all P > 0.05). Conclusions Donor age exerts no effect upon short-term survival of IPF patients after lung transplantation. Considering the mechanical ventilation time, oxygenation index, infection and other factors of donors, the age range of lung transplant donors may be expanded.
- Lung transplantation,
- Idiopathic pulmonary fibrosis,
- Donor age,
- Oxygenation index,
- Mechanical ventilation,
- N-terminal pro brain natriuretic peptide,
- Lung allocation score,
- Extracorporeal membrane oxygenation

FullText(HTML)

References(35)

References

[1]	RAGHU G, REMY-JARDIN M, RICHELDI L, et al. Idiopathic pulmonary fibrosis (an update) and progressive pulmonary fibrosis in adults: an official ATS/ERS/JRS/ALAT clinical practice guideline[J]. Am J Respir Crit Care Med, 2022, 205(9): e18-e47. DOI: 10.1164/rccm.202202-0399ST.
[2]	NOLAN CM, POLGAR O, SCHOFIELD SJ, et al. Pulmonary rehabilitation in idiopathic pulmonary fibrosis and COPD: a propensity-matched real-world study[J]. Chest, 2022, 161(3): 728-737. DOI: 10.1016/j.chest.2021.10.021.
[3]	IKEZOE K, HACKETT TL, PETERSON S, et al. Small airway reduction and fibrosis is an early pathologic feature of idiopathic pulmonary fibrosis[J]. Am J Respir Crit Care Med, 2021, 204(9): 1048-1059. DOI: 10.1164/rccm.202103-0585OC.
[4]	MACKINTOSH JA, CHAMBERS DC. Towards truly 'idiopathic' pulmonary fibrosis[J]. Respirology, 2022, 27(9): 682-683. DOI: 10.1111/resp.14320.
[5]	TZILAS V, TZOUVELEKIS A, RYU JH, et al. 2022 update on clinical practice guidelines for idiopathic pulmonary fibrosis and progressive pulmonary fibrosis[J]. Lancet Respir Med, 2022, 10(8): 729-731. DOI: 10.1016/S2213-2600(22)00223-5.
[6]	GEORGE PM, PATTERSON CM, REED AK, et al. Lung transplantation for idiopathic pulmonary fibrosis[J]. Lancet Respir Med, 2019, 7(3): 271-282. DOI: 10.1016/S2213-2600(18)30502-2.
[7]	VALAPOUR M, LEHR CJ, SKEANS MA, et al. OPTN/SRTR 2016 annual data report: lung[J]. Am J Transplant, 2018, 18(Suppl 1): 363-433. DOI: 10.1111/ajt.14562.
[8]	中国器官移植发展报告(2021)[M]. 北京: 中国科学技术出版社, 2022: 25-30.
[9]	REUL RM, LOOR G, GARCHA PS, et al. Allograft discard risk index for lung transplantation[J]. J Heart Lung Transplant, 2021, 40(12): 1658-1667. DOI: 10.1016/j.healun.2021.08.017.
[10]	VAN DER MARK SC, HOEK RAS, HELLEMONS ME. Developments in lung transplantation over the past decade[J]. Eur Respir Rev, 2020, 29(157): 190132. DOI: 10.1183/16000617.0132-2019.
[11]	CHRISTIE IG, CHAN EG, RYAN JP, et al. National trends in extended criteria donor utilization and outcomes for lung transplantation[J]. Ann Thorac Surg, 2021, 111(2): 421-426. DOI: 10.1016/j.athoracsur.2020.05.087.
[12]	VALAPOUR M, LEHR CJ, SKEANS MA, et al. OPTN/SRTR 2019 annual data report: lung[J]. Am J Transplant, 2021, 21(Suppl 2): 441-520. DOI: 10.1111/ajt.16495.
[13]	FISCHER S, GOHRBANDT B, STRUCKMEIER P, et al. Lung transplantation with lungs from donors fifty years of age and older[J]. J Thorac Cardiovasc Surg, 2005, 129(4): 919-925. DOI: 10.1016/j.jtcvs.2004.07.053.
[14]	RENARD R, GIRAULT A, AVRAMENKO-BOUVIER A, et al. Outcome of lung transplantation using grafts from donors over 65 years of age[J]. Ann Thorac Surg, 2021, 112(4): 1142-1149. DOI: 10.1016/j.athoracsur.2020.10.018.
[15]	GHAIDAN H, FAKHRO M, ANDREASSON J, et al. Ten year follow-up of lung transplantations using initially rejected donor lungs after reconditioning using ex vivo lung perfusion[J]. J Cardiothorac Surg, 2019, 14(1): 125. DOI: 10.1186/s13019-019-0948-1.
[16]	BITTLE GJ, SANCHEZ PG, KON ZN, et al. The use of lung donors older than 55 years: a review of the United Network of Organ Sharing database[J]. J Heart Lung Transplant, 2013, 32(8): 760-768. DOI: 10.1016/j.healun.2013.04.012.
[17]	MINEURA K, CHEN-YOSHIKAWA TF, TANAKA S, et al. Native lung complications after living-donor lobar lung transplantation[J]. J Heart Lung Transplant, 2021, 40(5): 343-350. DOI: 10.1016/j.healun.2021.01.1562.
[18]	CHOI AY, JAWITZ OK, RAMAN V, et al. Predictors of older donor lung use: are we too good at saying no?[J]. Ann Thorac Surg, 2020, 110(5): 1683-1690. DOI: 10.1016/j.athoracsur.2020.04.050.
[19]	SGALLA G, KULKARNI T, ANTIN-OZERKIS D, et al. Update in pulmonary fibrosis 2018[J]. Am J Respir Crit Care Med, 2019, 200(3): 292-300. DOI: 10.1164/rccm.201903-0542UP.
[20]	HU CX, CHEN WH, HE JX, et al. Lung transplantation in China between 2015 and 2018[J]. Chin Med J (Engl), 2019, 132(23): 2783-2789. DOI: 10.1097/CM9.0000000000000543.
[21]	焦国慧, 王梓涛, 陈静瑜. 肺移植全球发展概况与展望[J]. 器官移植, 2022, 13(4): 417-424. DOI: 10.3969/j.issn.1674-7445.2022.04.002. JIAO GH, WANG ZT, CHEN JY. Current status and prospect of global development of lung transplantation[J]. Organ Transplant, 2022, 13(4): 417-424. DOI: 10.3969/j.issn.1674-7445.2022.04.002.
[22]	吴波, 胡春晓, 李小杉, 等. 生命至上, 尊重科学——中国肺移植发展现状及展望述评[J]. 武汉大学学报(医学版), 2021, 42(4): 517-519. DOI: 10.14188/j.1671-8852.2021.6001. WU B, HU CX, LI XS, et al. Life first and science respect: a commentary on current status and expectations of China's lung transplantation[J]. Med J Wuhan Univ, 2021, 42(4): 517-519. DOI: 10.14188/j.1671-8852.2021.6001.
[23]	SHAH P, NEUJAHR DC. Lung transplantation: candidate selection and timing of transplant[J]. Curr Opin Organ Transplant, 2021, 26(3): 302-308. DOI: 10.1097/MOT.0000000000000879.
[24]	LEARD LE, HOLM AM, VALAPOUR M, et al. Consensus document for the selection of lung transplant candidates: sn update from the International Society for Heart and Lung Transplantation[J]. J Heart Lung Transplant, 2021, 40(11): 1349-1379. DOI: 10.1016/j.healun.2021.07.005.
[25]	HALL DJ, JENG EI, GREGG JA, et al. The impact of donor and recipient age: older lung transplant recipients do not require younger lungs[J]. Ann Thorac Surg, 2019, 107(3): 868-876. DOI: 10.1016/j.athoracsur.2018.09.066.
[26]	SHIN M, IYENGAR A, HELMERS MR, et al. Modern outcomes of heart-lung transplantation: assessing the impact of the updated US allocation system[J]. Eur J Cardiothorac Surg, 2022, 63(1): ezac559. DOI: 10.1093/ejcts/ezac559.
[27]	YUSEN RD, EDWARDS LB, DIPCHAND AI, et al. The Registry of the International Society for Heart and Lung Transplantation: thirty-third adult lung and heart-lung transplant report-2016; focus theme: primary diagnostic indications for transplant[J]. J Heart Lung Transplant, 2016, 35(10): 1170-1184. DOI: 10.1016/j.healun.2016.09.001.
[28]	LYU DM, GOFF RR, CHAN KM. The lung allocation score and its relevance[J]. Semin Respir Crit Care Med, 2021, 42(3): 346-356. DOI: 10.1055/s-0041-1729541.
[29]	KUMAR A, KAPNADAK SG, GIRGIS RE, et al. Lung transplantation in idiopathic pulmonary fibrosis[J]. Expert Rev Respir Med, 2018, 12(5): 375-385. DOI: 10.1080/17476348.2018.1462704.
[30]	CHAMBERS DC, CHERIKH WS, GOLDFARB SB, et al. The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: thirty-fifth adult lung and heart-lung transplant report-2018; focus theme: multiorgan transplantation[J]. J Heart Lung Transplant, 2018, 37(10): 1169-1183. DOI: 10.1016/j.healun.2018.07.020.
[31]	ANDER EH, KASHEM A, ZHAO H, et al. Lung transplant type and donor age in idiopathic pulmonary fibrosis: a single center study[J]. J Surg Res, 2022, 271: 125-136. DOI: 10.1016/j.jss.2021.10.027.
[32]	HAYES D JR, BLACK SM, TOBIAS JD, et al. Influence of donor and recipient age in lung transplantation[J]. J Heart Lung Transplant, 2015, 34(1): 43-49. DOI: 10.1016/j.healun.2014.08.017.
[33]	SOMMER W, IUS F, SALMAN J, et al. Survival and spirometry outcomes after lung transplantation from donors aged 70 years and older[J]. J Heart Lung Transplant, 2015, 34(10): 1325-1333. DOI: 10.1016/j.healun.2015.06.002.
[34]	MIGGINS JJ, REUL RM JR, LOOR G, et al. Trends in marginal lung allograft survival: advanced-age donors improve[J]. Clin Transplant, 2022, 36(9): e14777. DOI: 10.1111/ctr.14777.
[35]	BALDWIN MR, PETERSON ER, EASTHAUSEN I, et al Donor age and early graft failure after lung transplantation: a cohort study[J]. Am J Transplant, 2013, 13(10): 2685-2695. DOI: 10.1111/ajt.12428.

Relative Articles

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Figures(3) / Tables(2)

Get Citation

PDF

XML

Article Metrics

Article views (230) PDF downloads(39)

Effect of donor age on short-term survival of patients with idiopathic pulmonary fibrosis after lung transplantation

doi: 10.3969/j.issn.1674-7445.2023.03.014

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Effect of donor age on short-term survival of patients with idiopathic pulmonary fibrosis after lung transplantation

doi: 10.3969/j.issn.1674-7445.2023.03.014

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Export File

Citation

Format

Content