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Cardiothoracic Surgery in the Elderly pp 527–533Cite as

Lung Transplantation in the Elderly

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Abstract

Although lung transplantation became clinically widespread only during the 1990s, it is currently considered a standard treatment for a growing list of end-stage chronic lung diseases. With increasing experience, the range of ages of potential candidates for lung transplantation has been extended to now include more elderly patients. Although long term survival data shows an overall increased relative risk associated with elderly patients as compared with younger counterparts, lung transplantation remains a viable option for certain highly selected elderly patients. As is the case with most diseases, potential lung transplant patients at the upper extremes of age appropriately receive increased scrutiny in the preoperative evaluation process. Furthermore, in an effort to expand the donor organ pool, the age of potential cadaveric multiorgan donors considered for lung transplantation has extended into the elderly population. Considerations in lung transplantation particular to elderly recipients and elderly donors, including issues of patient selection as well as technical aspects relevant to lung transplantation in the elderly are the subject of this chapter.

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References

  1. Hardy JD, Webb WR, Dalton Jr ML, Walker Jr GR. Lung homotransplantation in man. JAMA. 1963;186:1065–74.

    Article  PubMed  CAS  Google Scholar 

  2. Toronto Lung Transplant Group. Unilateral lung transplantation for pulmonary fibrosis. N Engl J Med. 1986;314:1140–5.

    Article  Google Scholar 

  3. Cooper JD, Pearson FG, Patterson GA, Todd TR, Ginsberg RJ, Goldberg M, et al. Technique of successful lung transplantation in humans. J Thorac Cardiovasc Surg. 1987;93:173–81.

    PubMed  CAS  Google Scholar 

  4. Christie JD, Edwards LB, Aurora P, Dobbels F, Kirk R, Rahmel AO, et al. The registry of the international society for heart and lung transplantation: twenty-sixth official adult lung and heart-lung transplantation report-2009. J Heart Lung Transplant. 2009;28:1031–49.

    Article  PubMed  Google Scholar 

  5. Trulock EP, Egan TM, Kouchoukos NT, Kaiser LR, Pasque MK, Ettinger N, et al. Single lung transplantation for severe chronic obstructive pulmonary disease. Chest. 1989;96:738–42.

    Article  PubMed  CAS  Google Scholar 

  6. Cooper JD, Patterson GA, Grossman R, Maurer J, The Toronto Lung Transplant Group. Double-lung transplantation for advanced chronic obstructive lung disease. Am Rev Respir Dis. 1989;139:303–7.

    Article  PubMed  CAS  Google Scholar 

  7. Pasque MK, Cooper JD, Kaiser LR, Haydock DA, Triantafillou A, Trulock EP. Improved technique for bilateral lung transplantation: rationale and initial clinical experience. Ann Thorac Surg. 1990;49:785–91.

    Article  PubMed  CAS  Google Scholar 

  8. Orens JB, Estenne M, Arcasoy S, Conte JV, Corris P, Egan JJ, Egan T, Keshavjee S, Knoop C, Kotloff R, Martinez FJ, Nathan S, Palmer S, Patterson A, Singer L, Snell G, Studer S, Vachiery JL, Glanville AR; Pulmonary Scientific Council of the International Society for Heart and Lung Transplantation. International guidelines for the selection of lung transplant candidates: 2006 update – a consensus report from the Pulmonary Scientific Council of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2006;25:745–55.

    Google Scholar 

  9. Weiss ES, Merlo CA, Shah AS. Impact of advanced age in lung transplantation: an analysis of United Network for Organ Sharing data. J Am Coll Surg. 2009;208:400–9.

    Article  PubMed  Google Scholar 

  10. Mahidhara R, Bastani S, Ross DJ, Saggar R, Lynch 3rd J, Schnickel GT, et al. Lung transplantation in older patients? J Thorac Cardiovasc Surg. 2008;135:412–20.

    Article  PubMed  Google Scholar 

  11. Gutierrez C, Al-Faifi S, Chaparro C, Waddell T, Hadjiliadis D, Singer L, et al. The effect of recipient’s age on lung transplant outcome. Am J Transplant. 2007;7:1271–7.

    Article  PubMed  CAS  Google Scholar 

  12. Nwakanma LU, Simpkins CE, Williams JA, Chang DC, Borja MC, Conte JV, et al. Impact of bilateral versus single lung transplantation on survival in recipients 60 years of age and older: analysis of United Network for Organ Sharing database. J Thorac Cardiovasc Surg. 2007;133:541–7.

    Article  PubMed  Google Scholar 

  13. Palmer SM, Davis RD, Simsir SA, Lin SS, Hartwig M, Reidy MF, et al. Successful bilateral lung transplant outcomes in recipients 61 years of age and older. Transplantation. 2006;81:862–5.

    Article  PubMed  Google Scholar 

  14. Hadjiliadis D, Angel LF. Controversies in lung transplantation: are two lungs better than one? Semin Respir Crit Care Med. 2006;27:561–6.

    Article  PubMed  Google Scholar 

  15. Maurer JR, Frost AE, Estenne M, Higenbottam T, Glanville AR. International guidelines for the selection of lung transplant candidates. The International Society for Heart and Lung Transplantation, the American Thoracic Society, the American Society of Transplant Physicians, the European Respiratory Society. J Heart Lung Transplant. 1998;17:703–9.

    PubMed  CAS  Google Scholar 

  16. Cassivi SD, Meyers BF, Battafarano RJ, Guthrie TJ, Trulock EP, Lynch JP, et al. Thirteen-year experience in lung transplantation for emphysema. Ann Thorac Surg. 2002;74:1663–70.

    Article  PubMed  Google Scholar 

  17. Weiss ES, Allen JG, Merlo CA, Conte JV, Shah AS. Survival after single versus bilateral lung transplantation for high-risk patients with pulmonary fibrosis. Ann Thorac Surg. 2009;88:1616–26.

    Article  PubMed  Google Scholar 

  18. Thabut G, Christie JD, Ravaud P, Castier Y, Dauriat G, Jebrak G, et al. Survival after bilateral versus single-lung transplantation for idiopathic pulmonary fibrosis. Ann Intern Med. 2009;151:767–74.

    PubMed  Google Scholar 

  19. Chang AC, Chan KM, Lonigro RJ, Lau CL, Lama VN, Flaherty KR, et al. Surgical patient outcomes after the increased use of bilateral lung transplantation. J Thorac Cardiovasc Surg. 2007;133:532–40.

    Article  PubMed  Google Scholar 

  20. Smith PW, Wang H, Parini V, Zolak JS, Shen KR, Daniel TM, et al. Lung transplantation in patients 60 years and older: results, complications, and outcomes. Ann Thorac Surg. 2006;82:1835–41.

    Article  PubMed  Google Scholar 

  21. Fischer S, Meyer K, Tessmann R, Meyer A, Gohrbandt B, Simon A, et al. Outcome following single vs bilateral lung transplantation in recipients 60 years of age and older. Transplant Proc. 2005;37: 1369–70.

    Article  PubMed  CAS  Google Scholar 

  22. Miñambres E, Llorca J, Suberviola B, Naranjo S, Zurbano F, González-Castro A. Early outcome after single vs bilateral lung transplantation in older recipients. Transplant Proc. 2008;40(9):3088–9.

    Article  PubMed  Google Scholar 

  23. Snyder LD, Musselwhite LW, Palmer SW. Lung transplantation in the older patient. Curr Opin Organ Transplant. 2007;12:485–90.

    Article  Google Scholar 

  24. Meyer KC. Lung infections and aging. Ageing Res Rev. 2004;3: 55–67.

    Article  PubMed  Google Scholar 

  25. Ojo AO, Held PJ, Port FK, Wolfe RA, Leichtman AB, Young EW, et al. Chronic renal failure after transplantation of a nonrenal organ. N Engl J Med. 2003;349:931–40.

    Article  PubMed  CAS  Google Scholar 

  26. Choong CK, Meyers BF, Guthrie TJ, Trulock EP, Patterson GA, Moazami N. Does the presence of preoperative mild or moderate coronary artery disease affect the outcomes of lung transplantation? Ann Thorac Surg. 2006;82:1038–42.

    Article  PubMed  Google Scholar 

  27. Johnson SB, Allred AM, Cline AM, Angel LF, Sako EY, Baisden CE, et al. Cardiac procedures in lung transplant recipients do not increase mortality in selected patients. Ann Thorac Surg. 2006;82:460–4.

    Article  PubMed  Google Scholar 

  28. Audisio RA, Ramesh H, Longo WE, Zbar AP, Pope D. Preoperative assessment of surgical risk in oncogeriatric patients. Oncologist. 2005;10:262–8.

    Article  PubMed  Google Scholar 

  29. Narain P, Rubenstein LZ, Wieland GD, Rosbrook B, Strome LS, Pietruszka F, et al. Predictors of immediate and 6-month outcomes in hospitalized elderly patients. The importance of functional status. J Am Geriatr Soc. 1988;36:775–83.

    PubMed  CAS  Google Scholar 

  30. Mathur S, Hornblower E, Levy RD. Exercise training before and after lung transplantation. Phys Sportsmed. 2009;37:78–87.

    Article  PubMed  Google Scholar 

  31. Wickerson L, Mathur S, Brooks D. Exercise training after lung transplantation: a systematic review. J Heart Lung Transplant. 2010;29:497–503.

    Article  PubMed  Google Scholar 

  32. Bowdish ME, Pessotto R, Barbers RG, Schenkel FA, Starnes VA, Barr ML. Long-term pulmonary function after living-donor lobar lung transplantation in adults. Ann Thorac Surg. 2005;79:418–25.

    Article  PubMed  Google Scholar 

  33. Starnes VA, Bowdish ME, Woo MS, Barbers RG, Schenkel FA, Horn MV, et al. A decade of living lobar lung transplantation: recipient outcomes. J Thorac Cardiovasc Surg. 2004;127:114–22.

    Article  PubMed  Google Scholar 

  34. De Perrot M, Waddell TK, Shargall Y, Pierre AF, Fadel E, Uy K, et al. Impact of donors aged 60 years or more on outcome after lung transplantation: results of an 11-year single-center experience. J Thorac Cardiovasc Surg. 2007;133:525–31.

    Article  PubMed  Google Scholar 

  35. Fischer S, Gohrbandt B, Struckmeier P, Niedermeyer J, Simon A, Hagl C, et al. Lung transplantation with lungs from donors fifty years of age and older. J Thorac Cardiovasc Surg. 2005;129:919–25.

    Article  PubMed  Google Scholar 

  36. Dezza MC, Parigi PC, Corno V, Lucianetti A, Pinelli D, Zambelli M, et al. Lung transplantation with grafts from elderly donors: a single-center experience. Transplant Proc. 2010;42:1262–4.

    Article  PubMed  CAS  Google Scholar 

  37. Lingaraju R, Blumenthal NP, Kotloff RM, Christie J, Ahya VN, Sager JS, et al. Effects of lung allocation score on waiting list rankings and transplant procedures. J Heart Lung Transplant. 2006;25: 1167–70.

    Article  PubMed  Google Scholar 

  38. Kozower BD, Meyers BF, Smith MA, De Oliveira NC, Cassivi SD, Guthrie TJ, et al. The impact of the lung allocation score on short-term transplantation outcomes: a multicenter study. J Thorac Cardiovasc Surg. 2008;135:166–71.

    Article  PubMed  Google Scholar 

  39. Yusen RD, Shearon TH, Qian Y, Kotloff R, Barr ML, Sweet S, et al. Lung transplantation in the United States, 1999–2008. Am J Transplant. 2010;10:1047–68.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Lung Transplant Program, William J. von Liebig Transplant Center, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Juan J. Fibla

Authors
  1. Juan J. Fibla
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  2. Sandra C. Tomaszek
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  3. Stephen D. Cassivi
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Corresponding author

Correspondence to Juan J. Fibla .

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Editors and Affiliations

  1. , Department of Thoracic Surgery, Geisinger Wyoming Valley Medical Center, 1000 East Mountain Drive, Wilkes-Barre, 18711, Pennsylvania, USA

    Mark R. Katlic

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Fibla, J.J., Tomaszek, S.C., Cassivi, S.D. (2011). Lung Transplantation in the Elderly. In: Katlic, M. (eds) Cardiothoracic Surgery in the Elderly. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0892-6_44

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  • DOI: https://doi.org/10.1007/978-1-4419-0892-6_44

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  • Print ISBN: 978-1-4419-0891-9

  • Online ISBN: 978-1-4419-0892-6

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