Lung Transplantation in the Elderly

Although lung transplantation became clinically widespread only during the 1990s, it is currently considered a standard treatment for a growing list of end-stage chronic lung diseases. With increasing experience, the range of ages of potential candidates for lung transplantation has been extended to now include more elderly patients. Although long term survival data shows an overall increased relative risk associated with elderly patients as compared with younger counterparts, lung transplantation remains a viable option for certain highly selected elderly patients. As is the case with most diseases, potential lung transplant patients at the upper extremes of age appropriately receive increased scrutiny in the preoperative evaluation process. Furthermore, in an effort to expand the donor organ pool, the age of potential cadaveric multiorgan donors considered for lung transplantation has extended into the elderly population. Considerations in lung transplantation particular to elderly recipients and elderly donors, including issues of patient selection as well as technical aspects relevant to lung transplantation in the elderly are the subject of this chapter.