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Donor to recipient age matching in lung transplantation: A European experience

Lookup NU author(s): Dr Pauline Pradere, Professor Andrew FisherORCiD

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


Abstract

© 2024 The AuthorsBackground: The age profile of organ donors and patients on lung transplantation (LT) waiting lists have changed over time. In Europe, the donor population has aged much more rapidly than the recipient population, making allocation decisions on lungs from older donors common. In this study we assessed the impact of donor and recipient age discrepancy on LT outcomes in the UK and France. Methods: A retrospective analysis of all adult single or bilateral LT in France and the UK between 2010 and 2021. Recipients were stratified into 3 age author groups: young (≤30 years), middle-aged (30–60) and older (≥60). Their donors were also stratified into 2 groups <60, ≥60. Primary graft dysfunction (PGD) rates and recipient survival was compared between matched and mismatched donor and recipient age groups. Propensity matching was employed to minimize covariate imbalances and to improve the internal validity of our results. Results: Our study cohort was 4,696 lung transplant recipients (LTRs). In young and older LTRs, there was no significant difference in 1 and 5-year post-transplant survival dependent on the age category of the donor. Young LTRs who received older donor grafts had a higher risk of severe grade 3 PGD. Conclusion: Our findings show that clinically usable organs from older donors can be utilized safely in LT, even for younger recipients. Further research is needed to assess if the higher rate of PGD3 associated with use of older donors has an effect on long-term outcomes.


Publication metadata

Author(s): Pradere P, Le Pavec J, Morisset S, Gerovasili V, Kessler R, Adlakha A, Bunel V, Santhanakrishnan K, Demant X, Roux A, Falque L, Cottin V, Parmar J, Reynaud-Gaubert M, Villeneuve T, Tissot A, Mercier O, Fisher AJ

Publication type: Article

Publication status: Published

Journal: Journal of Heart and Lung Transplantation

Year: 2024

Pages: epub ahead of print

Online publication date: 20/06/2024

Acceptance date: 02/04/2024

Date deposited: 16/07/2024

ISSN (print): 1053-2498

ISSN (electronic): 1557-3117

Publisher: Elsevier Inc.

URL: https://doi.org/10.1016/j.healun.2024.06.008

DOI: 10.1016/j.healun.2024.06.008

PubMed id: 38909711


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Funding

Funder referenceFunder name
Groupe Hospitalier Paris Saint Joseph
National Institute for Health and Care Research (NIHR) Blood and Transplant Research Unit in Organ Donation and Transplantation
Newcastle University
NHS Blood and Transplant
NIHR203332
University of Cambridge

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