Lung Transplantation in the Elderly: Is Age a Contraindication?

This retrospective study analyzed outcomes of 970 bilateral lung transplant recipients at a single center from 2007–2023, stratified by age groups: 15–64, 65–69, 70–74, and 75–years. Findings showed that older recipients (greater than or equal to 65 years) had similar short-term outcomes, including 1-year survival rates, compared to younger patients, despite longer hospital stays and less frequent need for extracorporeal membrane oxygenation (ECMO) at 72 hours post-transplant. Median survival decreased with age: 6.1 years (15–64), 4.8 years (65–69), 4.7 years (70–74), and 4.5 years (75–79). Five-year survival rates were 58.0 percent, 46.8 percent, 44.5 percent, and 47.2 percent, respectively. Causes of death varied with age; graft failure was more common in younger patients, while infection, malignancy, and cardiovascular disease predominated in older groups. This study highlights the increasing acceptance of lung transplantation in elderly patients, especially those aged 70–74, demonstrating that careful selection can yield acceptable perioperative outcomes and that advanced age should not be considered an absolute contraindication for lung transplantation.