Isabelle Moneke, Ecem Deniz Ogutur, Anastasiya Kornyeva, Sebastian Fähndrich, David Schibilsky, Sibylle Bierbaum, Martin Czerny, Daiana Stolz, Bernward Passlick, Wolfgang Jungraithmayr, Bjoern Christian Frye
{"title":"捐献者年龄超过 55 岁与特发性肺纤维化肺移植受者较差的预后有关。","authors":"Isabelle Moneke, Ecem Deniz Ogutur, Anastasiya Kornyeva, Sebastian Fähndrich, David Schibilsky, Sibylle Bierbaum, Martin Czerny, Daiana Stolz, Bernward Passlick, Wolfgang Jungraithmayr, Bjoern Christian Frye","doi":"10.1186/s12890-024-03317-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Lung transplantation (LTx) remains the only efficient treatment for selected patients with end-stage pulmonary disease. The age limit for the acceptance of donor organs in LTx is still a matter of debate. We here analyze the impact of donor organ age and the underlying pulmonary disease on short- and long-term outcome and survival after LTx.</p><p><strong>Methods: </strong>Donor and recipient characteristics of LTx recipients at our institution between 03/2003 and 12/2021 were analyzed. Statistical analysis was performed using SPSS and GraphPad software.</p><p><strong>Results: </strong>In 230 patients analyzed, donor age ≥ 55 years was associated with a higher incidence of severe primary graft dysfunction (PGD2/3) (46% vs. 31%, p = 0.03) and reduced long-term survival after LTx (1-, 5- and 10-year survival: 75%, 54%, 37% vs. 84%, 76%, 69%, p = 0.006). Notably, this was only significant in recipients with idiopathic pulmonary fibrosis (IPF) (PGD: 65%, vs. 37%, p = 0.016; 1-, 5-, and 10-year survival: 62%, 38%, 16% vs. 80%, 76%, 70%, p = 0.0002 respectively). In patients with chronic obstructive pulmonary disease (COPD), donor age had no impact on the incidence of PGD2/3 or survival (21% vs. 27%, p = 0.60 and 68% vs. 72%; p = 0.90 respectively). Moreover, we found higher Torque-teno virus (TTV)-DNA levels after LTx in patients with IPF compared to COPD (X<sup>2</sup> = 4.57, p = 0.033). Donor age ≥ 55 is an independent risk factor for reduced survival in the whole cohort and patients with IPF specifically.</p><p><strong>Conclusions: </strong>In recipients with IPF, donor organ age ≥ 55 years was associated with a higher incidence of PGD2/3 and reduced survival after LTx. The underlying pulmonary disease may thus be a relevant factor for postoperative graft function and survival.</p><p><strong>Trial registration number dkrs: </strong>DRKS00033312.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"24 1","pages":"499"},"PeriodicalIF":2.6000,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465681/pdf/","citationCount":"0","resultStr":"{\"title\":\"Donor age over 55 is associated with worse outcome in lung transplant recipients with idiopathic pulmonary fibrosis.\",\"authors\":\"Isabelle Moneke, Ecem Deniz Ogutur, Anastasiya Kornyeva, Sebastian Fähndrich, David Schibilsky, Sibylle Bierbaum, Martin Czerny, Daiana Stolz, Bernward Passlick, Wolfgang Jungraithmayr, Bjoern Christian Frye\",\"doi\":\"10.1186/s12890-024-03317-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Lung transplantation (LTx) remains the only efficient treatment for selected patients with end-stage pulmonary disease. The age limit for the acceptance of donor organs in LTx is still a matter of debate. We here analyze the impact of donor organ age and the underlying pulmonary disease on short- and long-term outcome and survival after LTx.</p><p><strong>Methods: </strong>Donor and recipient characteristics of LTx recipients at our institution between 03/2003 and 12/2021 were analyzed. Statistical analysis was performed using SPSS and GraphPad software.</p><p><strong>Results: </strong>In 230 patients analyzed, donor age ≥ 55 years was associated with a higher incidence of severe primary graft dysfunction (PGD2/3) (46% vs. 31%, p = 0.03) and reduced long-term survival after LTx (1-, 5- and 10-year survival: 75%, 54%, 37% vs. 84%, 76%, 69%, p = 0.006). Notably, this was only significant in recipients with idiopathic pulmonary fibrosis (IPF) (PGD: 65%, vs. 37%, p = 0.016; 1-, 5-, and 10-year survival: 62%, 38%, 16% vs. 80%, 76%, 70%, p = 0.0002 respectively). In patients with chronic obstructive pulmonary disease (COPD), donor age had no impact on the incidence of PGD2/3 or survival (21% vs. 27%, p = 0.60 and 68% vs. 72%; p = 0.90 respectively). Moreover, we found higher Torque-teno virus (TTV)-DNA levels after LTx in patients with IPF compared to COPD (X<sup>2</sup> = 4.57, p = 0.033). Donor age ≥ 55 is an independent risk factor for reduced survival in the whole cohort and patients with IPF specifically.</p><p><strong>Conclusions: </strong>In recipients with IPF, donor organ age ≥ 55 years was associated with a higher incidence of PGD2/3 and reduced survival after LTx. The underlying pulmonary disease may thus be a relevant factor for postoperative graft function and survival.</p><p><strong>Trial registration number dkrs: </strong>DRKS00033312.</p>\",\"PeriodicalId\":9148,\"journal\":{\"name\":\"BMC Pulmonary Medicine\",\"volume\":\"24 1\",\"pages\":\"499\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2024-10-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465681/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Pulmonary Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12890-024-03317-x\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Pulmonary Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12890-024-03317-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
摘要
背景：肺移植（LTx）仍是治疗部分终末期肺病患者的唯一有效方法。关于接受肺移植供体器官的年龄限制仍存在争议。我们在此分析了供体器官年龄和潜在肺部疾病对肺移植术后短期和长期疗效及存活率的影响：方法：分析我院 2003 年 3 月至 2021 年 12 月期间接受 LTx 患者的供体和受体特征。采用 SPSS 和 GraphPad 软件进行统计分析：在分析的230例患者中，供体年龄≥55岁与严重原发性移植物功能障碍（PGD2/3）发生率较高（46% vs. 31%，P = 0.03）和LTx术后长期存活率降低（1年、5年和10年存活率：75%、54%、37% vs. 84%、76%、69%，P = 0.006）有关。值得注意的是，这只对特发性肺纤维化（IPF）受者有显著影响（PGD：65% vs. 37%，p = 0.016；1、5 和 10 年生存率：62%、38%、16% vs. 80%、76%、70%，p = 0.0002）。在慢性阻塞性肺病（COPD）患者中，供体年龄对PGD2/3的发生率和存活率没有影响（分别为21% vs. 27%, p = 0.60和68% vs. 72%; p = 0.90）。此外，我们还发现，与慢性阻塞性肺病相比，IPF患者在LTx后的Torque-teno病毒（TTV）-DNA水平更高（X2 = 4.57，P = 0.033）。供体年龄≥55岁是导致整个队列和IPF患者存活率降低的一个独立风险因素：结论：在IPF受者中，供体器官年龄≥55岁与PGD2/3发生率较高和LTx后存活率降低有关。因此，潜在的肺部疾病可能是影响术后移植物功能和存活率的相关因素：DRKS00033312.
Donor age over 55 is associated with worse outcome in lung transplant recipients with idiopathic pulmonary fibrosis.
Background: Lung transplantation (LTx) remains the only efficient treatment for selected patients with end-stage pulmonary disease. The age limit for the acceptance of donor organs in LTx is still a matter of debate. We here analyze the impact of donor organ age and the underlying pulmonary disease on short- and long-term outcome and survival after LTx.
Methods: Donor and recipient characteristics of LTx recipients at our institution between 03/2003 and 12/2021 were analyzed. Statistical analysis was performed using SPSS and GraphPad software.
Results: In 230 patients analyzed, donor age ≥ 55 years was associated with a higher incidence of severe primary graft dysfunction (PGD2/3) (46% vs. 31%, p = 0.03) and reduced long-term survival after LTx (1-, 5- and 10-year survival: 75%, 54%, 37% vs. 84%, 76%, 69%, p = 0.006). Notably, this was only significant in recipients with idiopathic pulmonary fibrosis (IPF) (PGD: 65%, vs. 37%, p = 0.016; 1-, 5-, and 10-year survival: 62%, 38%, 16% vs. 80%, 76%, 70%, p = 0.0002 respectively). In patients with chronic obstructive pulmonary disease (COPD), donor age had no impact on the incidence of PGD2/3 or survival (21% vs. 27%, p = 0.60 and 68% vs. 72%; p = 0.90 respectively). Moreover, we found higher Torque-teno virus (TTV)-DNA levels after LTx in patients with IPF compared to COPD (X2 = 4.57, p = 0.033). Donor age ≥ 55 is an independent risk factor for reduced survival in the whole cohort and patients with IPF specifically.
Conclusions: In recipients with IPF, donor organ age ≥ 55 years was associated with a higher incidence of PGD2/3 and reduced survival after LTx. The underlying pulmonary disease may thus be a relevant factor for postoperative graft function and survival.
期刊介绍：
BMC Pulmonary Medicine is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of pulmonary and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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