Hospitalizations, survival, and complications: 1-year outcomes for elderly lung transplant recipients Nicole Casciello, PharmD, MBA; Amaris Fuentes, PharmD; Jill Krisl, PharmD; Neeraj Sinha, MD; Thomas Kaleekal, MD PURPOSE
In 2014, The International Society for Heart and Lung Transplantation published consensus guidelines listing age greater than 65 years as a relative contraindication to lung transplant due to reduced physiologic reserve and presence of comorbidities that may lead to poorer outcomes. The purpose of this study is to assess clinical outcomes and posttransplant complications among elderly lung transplant recipients (LTR) as compared to younger cohorts at our institution. METHODS
This is a single center, retrospective, cohort study. Eligible patients received a single or double lung transplant between Jan. 1, 2012, and Dec. 31, 2014 and were 50 years or older at the time of transplant. Patients who received a redo lung or multi-organ transplant, or expired prior to discharge were excluded. The primary endpoint is number of days alive and outside a health care facility in the first year posttransplant.
p=0.04) and Caucasians (66.2% vs. 72.3% vs. 89.1%; p=0.01) compared to the youngest cohort. Lung allocation scores were similar among the cohorts (42.7±16.2 vs. 43.8±17.9 vs. 45±16; p=0.73); however, more patients in the two older cohorts received a single lung transplant (30.9% vs. 56.2% vs. 78.1%; p<0.01). Preliminary results suggest no difference in total days alive and outside a health care facility in the first year posttransplant (289.4±98.9 vs. 268.5±110.4 vs. 270.6±112.9 days; p=0.43), 1-year patient survival (91.2% vs. 83% vs. 81.3%; p=0.22), or total hospitalized days in the first year posttransplant (16.2±22.9 vs. 21.8±26.8 vs. 19.6±22.7 days; p=0.34). Furthermore, posttransplant length of stay (LOS) (16.3±8.7 vs. 18.6±12.2 vs. 15.2±8.8 days; p=0.10) and intensive care unit LOS (7.3±8.4 vs. 9.9±11.1 vs. 7.0±8.8 days; p=0.10) during the index admission were similar among the cohorts. A greater percentage of patients ages 60-69 years were discharged to long-term acute care facilities after the index admission (29.4% vs. 51.4% vs. 40.6%; p=0.02). CONCLUSION
RESULTS
Two hundred thirty-seven patients met eligibility criteria as follows: 50–59 years (n=68); 60-69 years (n=105); and greater than 70 years (n=64). The two older cohorts had a greater percentage of males (54.5% vs. 71.4% vs. 71.9%;
Preliminary data suggests outcomes in elderly LTR in the first year posttransplant may be similar to their younger counterparts.
PGY2 SOLID ORGAN TRANSPLANT RESIDENCY
Nicole Casciello, PharmD, MBA Nicole earned her BS in food marketing from Saint Joseph’s University, an MBA from The Wharton School at The University of Pennsylvania, and Doctor of Pharmacy from The University of Texas at Austin College of Pharmacy. Prior to pharmacy school, she served as a management consultant and marketing executive. Most recently, she completed her PGY1 Pharmacy Residency at Duke University Hospital. She has accepted a position as a heart and lung transplant clinical specialist at Indiana University Health. Primary project preceptor: Amaris Fuentes, PharmD, BCPS Presented at 2016 American Transplant Congress, Boston, Mass.
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