Association of cardiac disease with the risk of post-lung transplantation mortality in Chinese recipients aged over 65 years

AbstractThe current organ allocation rules prioritize elderly and urgent patients on the lung transplantation (LT) waiting list. A steady increase in the threshold at which age is taken into consideration for LT has been observed. This retrospective cohort study recruited 166 lung transplant recipients aged ≽ 65 years between January 2016 and October 2020 in the largest LT center in China. In the cohort, subgroups of patients aged 65–70 years (111 recipients, group 65–70) and ≽ 70 years (55 recipients, group ≽ 70) were included. Group D restrictive lung disease was the main indication of a lu ng transplant in recipients over 65 years. A significantly higher percentage of coronary artery stenosis was observed in the group ≽ 70 (30.9% vs. 14.4% in group 65–70,P = 0.014). ECMO bridging to LT was performed in 5.4% (group 65 –70) and 7.3% (group ≽ 70) of patients. Kaplan—Meier estimates showed that recipients with cardiac abnormalities had a significantly increased risk of mortality. After adjusting for potential confounders, cardiac abnormality was shown to be independently associated with the increased risk of p ost-LT mortality (HR 6.37,P = 0.0060). Our result showed that LT can be performed in candidates with an advanced age and can provide life-extending benefits.
Source: Frontiers of Medicine - Category: General Medicine Source Type: research