Impact of bilateral versus single lung transplantation on survival in recipients 60 years of age and older: Analysis of United Network for Organ Sharing database

Lois U. Nwakanma, Christopher E. Simpkins, Jason A. Williams, David C. Chang, Marvin C. Borja, John Conte, Ashish S. Shah

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Objective: Lung transplantation has been increasingly applied to patients over the age of 60 years. Importantly, the procedure of choice, single versus bilateral lung transplantation, remains unclear. Therefore, the purpose of this study was to examine short- and midterm outcomes in this age group with particular attention to procedure type. Methods: All first lung transplant recipients, 60 years of age or older, reported to the United Network for Organ Sharing from 1998 to 2004 were divided into two groups: bilateral and single lung transplantation. A retrospective review of pertinent baseline characteristics, clinical parameters, and outcomes was performed. Kaplan-Meier methodology was used to estimate and Cox proportional hazards regression modeling was used to compare posttransplant survival between these groups. Additionally, propensity scores analysis was performed. Results: During the study period, 1656 lung transplant recipients were 60 years of age or older (mean 62.7 ± 2.4 years, median 62 years). Of these, 364 (28%) had bilateral and 1292 (78%) had single lung transplantation. Survival was not statistically different between the two groups. In the multivariate analysis, bilateral versus single lung transplantation was not a predictor of mortality. Idiopathic pulmonary fibrosis and a donor tobacco history of more than 20 pack-years were significantly associated with mortality (P = .003, CI 1.12-1.76; and P = .006, CI 1.09-1.63; respectively). Conclusions: The survival of lung transplant recipients 60 years of age or older who underwent bilateral versus single lung transplantation is comparable. These data suggest that type of procedure is not a predictor of mortality in this age group. Idiopathic pulmonary fibrosis and donor cigarette use of more than 20 pack-years were independently associated with mortality.

Original languageEnglish (US)
Pages (from-to)541-547
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume133
Issue number2
DOIs
StatePublished - Feb 1 2007

Fingerprint

Lung Transplantation
Databases
Survival
Idiopathic Pulmonary Fibrosis
Mortality
Lung
Age Groups
Tissue Donors
Propensity Score
Tobacco Products
Tobacco
Multivariate Analysis
Transplant Recipients

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Nwakanma, Lois U. ; Simpkins, Christopher E. ; Williams, Jason A. ; Chang, David C. ; Borja, Marvin C. ; Conte, John ; Shah, Ashish S. / Impact of bilateral versus single lung transplantation on survival in recipients 60 years of age and older : Analysis of United Network for Organ Sharing database. In: Journal of Thoracic and Cardiovascular Surgery. 2007 ; Vol. 133, No. 2. pp. 541-547.
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abstract = "Objective: Lung transplantation has been increasingly applied to patients over the age of 60 years. Importantly, the procedure of choice, single versus bilateral lung transplantation, remains unclear. Therefore, the purpose of this study was to examine short- and midterm outcomes in this age group with particular attention to procedure type. Methods: All first lung transplant recipients, 60 years of age or older, reported to the United Network for Organ Sharing from 1998 to 2004 were divided into two groups: bilateral and single lung transplantation. A retrospective review of pertinent baseline characteristics, clinical parameters, and outcomes was performed. Kaplan-Meier methodology was used to estimate and Cox proportional hazards regression modeling was used to compare posttransplant survival between these groups. Additionally, propensity scores analysis was performed. Results: During the study period, 1656 lung transplant recipients were 60 years of age or older (mean 62.7 ± 2.4 years, median 62 years). Of these, 364 (28{\%}) had bilateral and 1292 (78{\%}) had single lung transplantation. Survival was not statistically different between the two groups. In the multivariate analysis, bilateral versus single lung transplantation was not a predictor of mortality. Idiopathic pulmonary fibrosis and a donor tobacco history of more than 20 pack-years were significantly associated with mortality (P = .003, CI 1.12-1.76; and P = .006, CI 1.09-1.63; respectively). Conclusions: The survival of lung transplant recipients 60 years of age or older who underwent bilateral versus single lung transplantation is comparable. These data suggest that type of procedure is not a predictor of mortality in this age group. Idiopathic pulmonary fibrosis and donor cigarette use of more than 20 pack-years were independently associated with mortality.",
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Impact of bilateral versus single lung transplantation on survival in recipients 60 years of age and older : Analysis of United Network for Organ Sharing database. / Nwakanma, Lois U.; Simpkins, Christopher E.; Williams, Jason A.; Chang, David C.; Borja, Marvin C.; Conte, John; Shah, Ashish S.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 133, No. 2, 01.02.2007, p. 541-547.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of bilateral versus single lung transplantation on survival in recipients 60 years of age and older

T2 - Analysis of United Network for Organ Sharing database

AU - Nwakanma, Lois U.

AU - Simpkins, Christopher E.

AU - Williams, Jason A.

AU - Chang, David C.

AU - Borja, Marvin C.

AU - Conte, John

AU - Shah, Ashish S.

PY - 2007/2/1

Y1 - 2007/2/1

N2 - Objective: Lung transplantation has been increasingly applied to patients over the age of 60 years. Importantly, the procedure of choice, single versus bilateral lung transplantation, remains unclear. Therefore, the purpose of this study was to examine short- and midterm outcomes in this age group with particular attention to procedure type. Methods: All first lung transplant recipients, 60 years of age or older, reported to the United Network for Organ Sharing from 1998 to 2004 were divided into two groups: bilateral and single lung transplantation. A retrospective review of pertinent baseline characteristics, clinical parameters, and outcomes was performed. Kaplan-Meier methodology was used to estimate and Cox proportional hazards regression modeling was used to compare posttransplant survival between these groups. Additionally, propensity scores analysis was performed. Results: During the study period, 1656 lung transplant recipients were 60 years of age or older (mean 62.7 ± 2.4 years, median 62 years). Of these, 364 (28%) had bilateral and 1292 (78%) had single lung transplantation. Survival was not statistically different between the two groups. In the multivariate analysis, bilateral versus single lung transplantation was not a predictor of mortality. Idiopathic pulmonary fibrosis and a donor tobacco history of more than 20 pack-years were significantly associated with mortality (P = .003, CI 1.12-1.76; and P = .006, CI 1.09-1.63; respectively). Conclusions: The survival of lung transplant recipients 60 years of age or older who underwent bilateral versus single lung transplantation is comparable. These data suggest that type of procedure is not a predictor of mortality in this age group. Idiopathic pulmonary fibrosis and donor cigarette use of more than 20 pack-years were independently associated with mortality.

AB - Objective: Lung transplantation has been increasingly applied to patients over the age of 60 years. Importantly, the procedure of choice, single versus bilateral lung transplantation, remains unclear. Therefore, the purpose of this study was to examine short- and midterm outcomes in this age group with particular attention to procedure type. Methods: All first lung transplant recipients, 60 years of age or older, reported to the United Network for Organ Sharing from 1998 to 2004 were divided into two groups: bilateral and single lung transplantation. A retrospective review of pertinent baseline characteristics, clinical parameters, and outcomes was performed. Kaplan-Meier methodology was used to estimate and Cox proportional hazards regression modeling was used to compare posttransplant survival between these groups. Additionally, propensity scores analysis was performed. Results: During the study period, 1656 lung transplant recipients were 60 years of age or older (mean 62.7 ± 2.4 years, median 62 years). Of these, 364 (28%) had bilateral and 1292 (78%) had single lung transplantation. Survival was not statistically different between the two groups. In the multivariate analysis, bilateral versus single lung transplantation was not a predictor of mortality. Idiopathic pulmonary fibrosis and a donor tobacco history of more than 20 pack-years were significantly associated with mortality (P = .003, CI 1.12-1.76; and P = .006, CI 1.09-1.63; respectively). Conclusions: The survival of lung transplant recipients 60 years of age or older who underwent bilateral versus single lung transplantation is comparable. These data suggest that type of procedure is not a predictor of mortality in this age group. Idiopathic pulmonary fibrosis and donor cigarette use of more than 20 pack-years were independently associated with mortality.

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