[Early outcomes following lung transplantation in patients aged 65 years and older]

A Avramenko-Bouvier; G Weisenburger; G Jebrak; P Cerceau; Q Pellenc; A Roussel; V Bunel; C Godet; J Messika; P Montravers; Y Castier; H Mal; P Mordant

doi:10.1016/j.rmr.2020.08.012

[Early outcomes following lung transplantation in patients aged 65 years and older]

Rev Mal Respir. 2020 Dec;37(10):769-775. doi: 10.1016/j.rmr.2020.08.012. Epub 2020 Nov 4.

[Article in French]

Authors

A Avramenko-Bouvier¹, G Weisenburger², G Jebrak², P Cerceau¹, Q Pellenc³, A Roussel⁴, V Bunel², C Godet², J Messika⁵, P Montravers⁶, Y Castier⁴, H Mal⁵, P Mordant⁷

Affiliations

¹ Service de Chirurgie vasculaire, thoracique, et transplantation pulmonaire, Hôpital Bichat - Claude-Bernard, Assistance publique-Hôpitaux de Paris, Université de Paris, 75018 Paris, France.
² Service de Pneumologie B et transplantation pulmonaire, Hôpital Bichat - Claude-Bernard, Assistance publique-Hôpitaux de Paris, Université de Paris, 75018 Paris, France.
³ Service de Chirurgie vasculaire, thoracique, et transplantation pulmonaire, Hôpital Bichat - Claude-Bernard, Assistance publique-Hôpitaux de Paris, Université de Paris, 75018 Paris, France; Inserm 1148, UFR Diderot, Université de Paris, 75018 Paris, France.
⁴ Service de Chirurgie vasculaire, thoracique, et transplantation pulmonaire, Hôpital Bichat - Claude-Bernard, Assistance publique-Hôpitaux de Paris, Université de Paris, 75018 Paris, France; Inserm 1152, UFR Diderot, Université de Paris, 75018 Paris, France.
⁵ Service de Pneumologie B et transplantation pulmonaire, Hôpital Bichat - Claude-Bernard, Assistance publique-Hôpitaux de Paris, Université de Paris, 75018 Paris, France; Inserm 1152, UFR Diderot, Université de Paris, 75018 Paris, France.
⁶ Département d'Anesthésie-réanimation, Hôpital Bichat - Claude-Bernard, Assistance publique-Hôpitaux de Paris, Université de Paris, 75018 Paris, France; Inserm 1152, UFR Diderot, Université de Paris, 75018 Paris, France.
⁷ Service de Chirurgie vasculaire, thoracique, et transplantation pulmonaire, Hôpital Bichat - Claude-Bernard, Assistance publique-Hôpitaux de Paris, Université de Paris, 75018 Paris, France; Inserm 1152, UFR Diderot, Université de Paris, 75018 Paris, France. Electronic address: pierre.mordant@aphp.fr.

PMID: 33158640
DOI: 10.1016/j.rmr.2020.08.012

Abstract

Introduction: The number of lung transplantations performed is increasing worldwide. With an improved experience and outcomes, the age of the recipient on its own has ceased to be an absolute contra-indication. We report our first experience with lung transplantation in patients aged 65 years or older.

Methods: From January 2014 to March 2019, the files of patients aged 65 years or older undergoing lung transplantation were retrospectively reviewed.

Results: During the study period, 241 patients underwent lung transplantation in Bichat hospital (Paris, France), including 25 recipients aged 65 years or older. Underlying diagnoses were interstitial (72%) and obstructive (28%) disease. The rate of single lung transplantation was 80%. Sixteen patients required ECMO assistance during the procedure. Early complications were mostly grade III primary graft dysfunction (12%) and cellular rejection (20%). Overall one-year survival rate was 76%.

Conclusion: After a careful selection of the recipients, the early results of our retrospective single center series are encouraging. We continue to consider lung transplantation in rigorously selected recipients of aged 65 years and more.

Keywords: Chronic respiratory failure; Elderly; Insuffisance respiratoire chronique; Lung transplantation; Patients âgés; Transplantation pulmonaire.

MeSH terms

Age Factors
Age of Onset
Aged
Aged, 80 and over
Female
France / epidemiology
Graft Survival
Humans
Lung Diseases, Interstitial / epidemiology*
Lung Diseases, Interstitial / mortality
Lung Diseases, Interstitial / therapy*
Lung Diseases, Obstructive / epidemiology*
Lung Diseases, Obstructive / mortality
Lung Diseases, Obstructive / therapy*
Lung Transplantation* / adverse effects
Lung Transplantation* / methods
Lung Transplantation* / mortality
Lung Transplantation* / statistics & numerical data
Male
Paris / epidemiology
Postoperative Period
Primary Graft Dysfunction / epidemiology
Retrospective Studies
Survival Rate
Time Factors
Treatment Outcome