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Observational Study
. 2024 Oct;43(10):1716-1726.
doi: 10.1016/j.healun.2024.06.008. Epub 2024 Jun 21.

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

P Pradere  1 , J Le Pavec  2 , S Morisset  3 , V Gerovasili  4 , R Kessler  5 , A Adlakha  6 , V Bunel  7 , K Santhanakrishnan  8 , X Demant  9 , A Roux  10 , L Falque  11 , V Cottin  12 , J Parmar  13 , M Reynaud-Gaubert  14 , T Villeneuve  15 , A Tissot  16 , O Mercier  17 , A J Fisher  18
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Free article
Observational Study

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

P Pradere et al. J Heart Lung Transplant. 2024 Oct.
Free article

Abstract

Background: 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.

Keywords: age matching; donor age; lung transplantation; post-transplant survival; recipient age.

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Conflict of interest statement

Disclosure statement P. Pradère, J. Le Pavec, S. Morisset, V. Gerovasili, R. Kessler, A. Adlakha, V. Bunel, K. Santhanakrishnan, X. Demant, A. Roux, L. Falque, V. Cottin, J. Parmar, M. Reynaud-Gaubert, T. Villeneuve, A. Tissot have nothing to declare related to the content of the manuscript. O. Mercier reports grants from Edwards Lifescience outside the scope of the submitted work. A.J. Fisher reports institutional grant funding from NIHR Blood and Transplant Research Unit, consultancy and non-financial support from Mallinckrodt Pharmaceuticals, consultancy from Altavant and Sanofi, and grants from Pfizer and Chiesi, all outside the scope of the submitted work.

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