Is Donor Age a Limit for Lung Transplantation? A Report of Two Cases

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Abstract

Introduction

Data from international registries shows that, in the last decade, there has been an age increase in lung donors. Despite this trend, there are still groups that reject organs exclusively by age criteria. We present two cases of effective donors over the age of 75 years.

Methods

Retrospective study (January 2001 - April 2017). We reviewed the Spanish National Registry of donors carried out by National Transplant Organization (ONT). All potential lung donors offered to the ONT were recorded and we identified those above 75 years. Recipients characteristics, surgical complications and evolution of lungs > 75 years were evaluated.

Results

During the period studied, 3886potential lung donors were offered to the ONT and 301 (7,7%) of them were above 65 years (Fig. 1). Of the 301 donors above 65, 232 (77,1%) were implanted. Of the discarded lungs >65, 25 cases (8,3%) were due only to age reasons. We identified only two donors above 75 that constitute the cases that we present in this review. Case 1 was an 86-year-old woman who suffered a massive intracranial hemorrhage and was admitted to the ICU as possible organ donor with family consent. Brain death occurred after 10 days and she was an effective liver and right lung donor. The lung was implanted in a 67 years old man with idiopathic pulmonary fibrosis without complications. He was discharged from the hospital after one month and is still alive and well twelve months after the transplant. Case 2 was a 79-year-old woman also with a massive intracranial bleedingadmitted to ICUas possible donor with family consent. After 24-hours she was pronounced brain death and was an effective donor of both lungs. The bipulmonary recipient was a 61-year-old female with chronic hypersensitivity pneumonitis. She was discharged from the hospital after 1 month without complications and six months after the transplant she has suffered no complications.

Conclusion

There is no conclusive evidence that suggest that donor age could be determinant in the course of the lung transplantation but there is still reluctance to accept these organs. Our experience with transplant patients receiving older lung donors is limited but positive.

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