HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (22) Citing Articles via Google Scholar Google Scholar Articles by Meyer, D. M. Articles by Hosenpud, J. D. Search for Related Content PubMed PubMed Citation Articles by Meyer, D. M. Articles by Hosenpud, J. D.

Effect of Donor Age and Ischemic Time on Intermediate Survival and Morbidity After Lung Transplantation^*

^* From the Division of Thoracic and Cardiovascular Surgery (Dr. Meyer), University of Texas Southwestern Medical Center at Dallas, TX; UNOS/ISHLT Registry (Dr. Bennett), Richmond, VA; London Health Sciences Centre (Dr. Novick), London, Ontario, Canada; and St. Luke’s Medical Center (Dr. Hosenpud), Milwaukee, WI.

Correspondence to: Dan M. Meyer, MD, Department of Surgery, Division of Thoracic and Cardiovascular Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75235-8879; e-mail: dan.meyer{at}email.swmed.edu

Background: Pressure to expand the donor pool has required the use of lungs from older donors or from more-distant procurement areas. The long-term consequences of this policy have not yet been fully addressed. The effect of donor age and donor ischemic time on intermediate survival and important secondary end points after lung transplantation was therefore examined.

Methods: A cohort of 1,800 lung transplant recipients with complete 2-year follow-up, operated on in the United States between April 1, 1993, and March 31, 1996, was studied to assess survival. For analysis of secondary end points, the cohort was limited to 1,450 patients.

Results: Donor age when analyzed independently did not significantly affect intermediate survival (p = 0.4). Secondary end points were also not affected by age, with the exception of the incidence of hospitalization for rejection in the univariate analysis (p = 0.02) and in the multivariate analysis (p = 0.04). Moreover, there was not a significant impact of donor age or ischemic time independently on survival in the multivariate analysis. Similarly, when the interaction between ischemic time and donor age was examined in all of the multivariate models, none of the secondary end points were found to be significantly influenced. However, the combined interaction between donor age and ischemia time demonstrated a significantly worse survival at 2 years (p = 0.02) with donor age of > 50 years and donor ischemic time > 7 h.

Conclusions: Donor age and donor ischemic time did not independently influence survival or important secondary end points after lung transplantation. However, intermediate-term survival was affected by the use of older donors when combined with a prolonged ischemic time. The impact of this combination should be considered when attempting to expand the donor pool.

Key Words: donor age • ischemic time • lung transplantation

This article has been cited by other articles:

				I. Al-Githmi, N. Batawil, N. Shigemura, M. Hsin, T. W. lee, G.-W. He, and A. Yim Bronchiolitis obliterans following lung transplantation Eur. J. Cardiothorac. Surg., December 1, 2006; 30(6): 846 - 851. [Abstract] [Full Text] [PDF]

				C. Aigner, G. Winkler, P. Jaksch, G. Seebacher, G. Lang, S. Taghavi, W. Wisser, and W. Klepetko Extended donor criteria for lung transplantation--a clinical reality Eur. J. Cardiothorac. Surg., May 1, 2005; 27(5): 757 - 761. [Abstract] [Full Text] [PDF]

				S. Fischer, B. Gohrbandt, P. Struckmeier, J. Niedermeyer, A. Simon, C. Hagl, K. Kallenbach, A. Haverich, and M. Struber Lung transplantation with lungs from donors fifty years of age and older J. Thorac. Cardiovasc. Surg., April 1, 2005; 129(4): 919 - 925. [Abstract] [Full Text] [PDF]

				S.M. Studer, R.D. Levy, K. McNeil, and J.B. Orens Lung transplant outcomes: a review of survival, graft function, physiology, health-related quality of life and cost-effectiveness Eur. Respir. J., October 1, 2004; 24(4): 674 - 685. [Abstract] [Full Text] [PDF]

				J. D. Christie, R. M. Kotloff, A. Pochettino, S. M. Arcasoy, B. R. Rosengard, J. R. Landis, and S. E. Kimmel Clinical Risk Factors for Primary Graft Failure Following Lung Transplantation Chest, October 1, 2003; 124(4): 1232 - 1241. [Abstract] [Full Text] [PDF]

				B. A. Johnson, A. T. Iacono, A. Zeevi, K. R. McCurry, and S. R. Duncan Statin Use Is Associated with Improved Function and Survival of Lung Allografts Am. J. Respir. Crit. Care Med., May 1, 2003; 167(9): 1271 - 1278. [Abstract] [Full Text] [PDF]

				B. P. Griffith and R. S. Poston Immunobiology of Heart and Heart-Lung Transplantation Card. Surg. Adult, January 1, 2003; 2(2003): 1403 - 1426. [Full Text]