When it comes to surgery, seniors are often told they can’t go under the knife — regardless of how severe their condition may be — due to their age. Yes, seniors do face extra challenges when it comes to surgery, but it doesn’t mean that they have to forgo a potentially lifesaving procedure. When it comes to lung transplantation, for example, it’s often been contended that seniors do not always make good candidates for the procedure, even though this may not be the case.
According to a new study that was just published in The Annals of Thoracic Surgery, the guidelines that were written back in 1998 may not be valid anymore, especially when it comes to determining whether or not seniors should undergo lung transplant surgery. Before we look at the study, let’s review what is involved in the lung transplantation process.
The very first lung transplant was performed over 20 years ago, back in 1983. Also known as LTX for short, there are two main types of lung transplants that are performed: bilateral lung transplantation (BLT) and single lung transplantation (SLT). Since the supply rate of this vital organ is low — and typically senior mortality is considered to be high — candidacy for LTX was usually reserved for younger adults. However, the age brackets for the procedure have been raised a bit since 1983. The age for BLT now sits at 60 and the age for SLT is at 65.
These age brackets were determined by a retrospective review of case studies and survival rates. In the study, the researchers reviewed 182 LTX cases that took place at the University of Virginia between 1995 and 2005. From this number, 52 patients (29%) were between the ages of 60 and 69 years. Another 16 transplant recipients (9%) were 65 years old and up.
The University of Virginia Health System is now looking to see whether or not these age brackets should be revised further to include older individuals. This demographic is rising in the United States — and more and more seniors may need to undergo LTX. Also, seniors who undergo LTX are potentially facing stronger survival rates thanks to good long-term post-surgery care.
According to Dr. David R. Jones, the surgical director of University of Virginia’s Lung Transplant Program, “Our findings show that the quality of care provided during the very early period following a lung transplant is key to long- term success for elderly recipients. We’ve established a multidisciplinary team to ensure that optimal care is provided during this crucial time.”
He also added that age should not be a reason to exclude seniors who are eligible for the surgery. “Age is not an independent exclusion criterion at our center,” noted Jones. “All patients undergo the same pre-transplant evaluation to determine their eligibility. Our study shows that lung transplantation can be performed with acceptable outcomes in patients aged 60 and older, if the person is otherwise an appropriate candidate.”
It should also be noted that the majority of seniors who undergo this surgery receive a single lung only, or an SLT. According to the researchers, it is the most effective form of lung transplantation for patients 60 and over.