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.

中文翻译：

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肺移植中供体与受体年龄匹配：欧洲经验。


背景技术 器官捐献者和肺移植（LT）等待名单上的患者的年龄特征随着时间的推移而发生变化。在欧洲，捐赠者群体的老龄化速度比接受者群体要快得多，这使得老年捐赠者的肺部分配决定很常见。在这项研究中，我们评估了英国和法国捐赠者和接受者年龄差异对 LT 结局的影响。方法 对 2010 年至 2021 年间法国和英国所有成人单侧或双侧 LT 进行回顾性分析。作者将接受者分为 3 个年龄组：年轻（≤30 岁）、中年（30-60 岁）和老年（≥60 岁） ）。他们的捐赠者也分为 2 组 <60，≥60。对匹配和不匹配的供体和受体年龄组之间的原发性移植物功能障碍（PGD）率和受体存活率进行了比较。采用倾向匹配来最小化协变量不平衡并提高我们结果的内部有效性。结果 我们的研究队列有 4,696 名肺移植受者 (LTR)。在年轻和年长的 LTR 中，移植后 1 年和 5 年的存活率没有显着差异，具体取决于捐赠者的年龄类别。接受较老供体移植物的年轻 LTR 发生严重 3 级 PGD 的风险更高。结论 我们的研究结果表明，来自老年捐献者的临床可用器官可以在 LT 中安全使用，即使对于年轻的受者也是如此。需要进一步的研究来评估与使用老年捐赠者相关的更高的 PGD3 率是否对长期结果有影响。