Lung Transplant From Older Donors Not Associated With Negative Outcomes

A retrospective review by Vijay Subramanian, MD, and colleagues found that lung transplants from donors aged 55 and older do not increase the risk of rejection or decrease one-year survival compared to younger donors. The study, which analyzed transplants from January 1, 2022, to December 31, 2024, suggests that expanding age criteria could safely increase the available donor pool.

Why does donor age matter for lung transplants?

The scarcity of suitable donor lungs creates a serious challenge for patients with end-stage lung disease. Current selection criteria often exclude donors aged 55 years and older, which limits the number of available organs and increases wait times for patients.

While some centers have considered using older donors to solve this shortage, medical professionals previously lacked clarity on how donor age affects outcomes after the transplant.

Did You Know? In this specific review of 136 donors, only 22 donors were 55 years of age or older, meaning 16.2% of the transplant recipients received lungs from this older age group.

What did the study find regarding survival and rejection?

According to the data from Vijay Subramanian, MD, and colleagues, donor age did not significantly affect one-year survival, citing a P-value of 0.604. The researchers found that rejection rates at one year were nearly identical between the two groups.

Specifically, the group receiving lungs from donors under 55 had a rejection rate of 59.6%, while the group receiving lungs from donors 55 and older had a rate of 59.1%. The study also noted that ischemic times and lung perfusion rates were comparable across both groups.

Expert Insight: Samantha Carter notes that the data suggests a critical trade-off: while older donors may lead to higher immediate post-surgical needs, they do not appear to compromise the long-term viability of the graft or the life of the patient.

How do older donors affect short-term recovery?

The study identified one notable difference in short-term outcomes. Recipients of lungs from donors aged 55 and older had a higher rate of intubation at 72 hours after the transplant.

Lung transplant candidates receiving older donor lungs have similar survival outcome

The intubation rate for the older donor group was 36.4%, compared to 18.4% for those who received lungs from donors under 55. Despite this, the authors noted that most donors in both groups were brain dead and nearly all lungs had perfusion.

What could happen next for transplant criteria?

The authors concluded that using lungs from donors 55 and older was not associated with increased rejection or decreased survival at one year. Based on these findings, expanding donor age criteria could safely increase the donor pool without compromising short-term outcomes.

Medical centers may be more likely to consider older donors as a viable solution to reduce long wait times for patients with end-stage lung disease.

Frequently Asked Questions

Did donor age impact the one-year survival rate?
No. According to the review by Vijay Subramanian, MD, and colleagues, donor age did not significantly affect one-year survival (P=0.604).

Was there a difference in rejection rates between the two groups?
Rejection rates were similar, with 59.6% in the under-55 group and 59.1% in the 55-and-older group.

What was the primary difference in recovery for recipients of older lungs?
Recipients of lungs from donors aged 55 and older had a higher rate of intubation at 72 hours after transplant (36.4%) compared to those with younger donors (18.4%).

Do you believe expanding donor age limits is the most effective way to reduce organ transplant wait times?