N. Kotler1, M. Azuma1, Y. Toyoda1, M. Kashem1 1Temple University, Philadelpha, PA, USA
Introduction: Lung transplantation in a younger population usually correlates with better outcomes. This abstract uses both single lung transplant (SLTx) and double lung transplant (DLTx) data from a single surgeon at a high-volume transplant center, to compare the impact of patient age on outcomes, with the goal to inform future practices.
Methods: There was a retrospective analysis of all lung transplant data from a single surgeon from February 2012 to May 2024 (n=552). Patients were grouped by age into 18-69 years old, 70-74 years old, or 75+ years old. These groups were evaluated for the patient sex and race; donor age and sex; lung allocation score (LAS); warm ischemic time (for both right and left lungs); median length of stay (LOS); use of post-operative ECMO (POE); and induction type. Analysis was performed with JMP Inc. (version 17.0). P-values less than .05 were considered to be significant.
Results: The patient sex difference across the groups was insignificant (p=0757). The 75+ group had the highest percentage of white patients (p=.0034). Donor age (p=.4397) and donor sex (p=.1273) were both insignificant. Patients 18-69 had the highest average LAS (p=.0006). Right and left warm ischemic time were insignificant across the groups (p=.7510 and p=.5063 respectively). Patients in the 18-69 group had the highest median LOS at 17.5 days. The use of POE was insignificant across the groups (p=.5082). The 70-74 group had the largest percentage of simulect induction (p=<.0001). Kaplan Meir analysis of five-year survival showed no significant difference between 18-69, 70-74, and 75+ (p=.1528), an insignificant difference between five-year survival of 18-69 and 75+ (p=.0631), no difference between 18-69 and 70-74 (p=.3188), and no difference between 70-74 and 75+ (p=.3533). There were no significant five-year survival differences between SLTx and DLTx in the 18-69 group (p=.7638) and the 70-74 group (p=.1827). In the 75+ group, the SLTx group had better survival outcomes (p=.0025).
Conclusion:
This analysis does not support the notion that younger patients have better outcomes as no age group has a significant difference in outcomes, suggesting that the impact of age may not be as significant of a variable. The experiences of a single surgeon may vary from others in a high-volume lung transplant setting.