Lung transplantation in the older patient

PURPOSE OF REVIEW: Lung transplantation remains controversial in older patients. This review will critically evaluate the current literature on the practice and outcomes in older lung transplantation recipients. RECENT FINDINGS: International Society of Heart and Lung Transplant guidelines recommended upper age limits for lung transplantation. Increasing numbers of transplant centers, however, are offering lung transplantation to older patients up to and exceeding these guidelines. In fact, patients over 65 years represent the fastest growing group of lung transplantation recipients in recent years. Current literature documents that acceptable short- and medium-term outcomes can be achieved in the older lung transplantation recipient although there are unique considerations in this age cohort including infections and renal dysfunction. In contrast to earlier reports, recent studies suggest that bilateral transplantation is an effective therapy in older patients with endstage lung disease. SUMMARY: Outcomes in the older lung transplantation recipients are acceptable. In this population, however, there are special considerations in the pretransplant, perioperative and posttransplant phases. Importantly, current allocation systems allow for, and can even favor, older lung transplantation recipients, suggesting the number of lung transplantation in older recipients is likely to continue to increase. © 2007 Lippincott Williams & Wilkins, Inc.

Duke Scholars

Author Laurie D. Snyder Medicine, Pulmonary, Allergy, and Critical Care Medicine

Author Scott Michael Palmer Jr. Medicine, Pulmonary, Allergy, and Critical Care Medicine