Postoperative Lung Transplant Considerations in the Older Recipient.

Abstract

Lung transplantation (LTx) remains the ultimate treatment for many patients with advanced lung disease. Although the age cutoffs for LTx have been debated due to variable outcomes, the number of LTx procedures performed on patients aged ≥ 65 years has significantly increased in recent decades, reflecting the realities of an aging demographic. This trend underscores the unique management challenges faced by this cohort and highlights the importance of addressing evidence gaps in their perioperative and postoperative care. This literature review highlights that, despite the challenges, recent data indicate favorable outcomes for patients aged ≥ 65 years undergoing LTx. Although this article primarily focuses on postoperative care, it also addresses some perioperative considerations, including the use of extracorporeal life support as well as the choice of the procedure type and donor considerations. It additionally incorporates current knowledge about early and late postoperative complications, including neurologic, cardiovascular, and renal, among others, along with their management strategies and current practice patterns. In conclusion, this review emphasizes the need to optimize care for older LTx recipients. The evidence regarding ideal management practices for this population is limited. We highlight the necessity for comprehensive postoperative management guidelines and identify key areas for further research to establish evidence-based protocols for this growing demographic.