Lung Transplant: A Surprising Option After Age 65

How to tell if it's right for you

Lung Transplant: A Surprising Option After Age 65

If you’re in your mid-60s or older and you have end-stage lung disease, you may wonder if you are eligible for a lung transplant. You may worry about being too advanced in age for such a serious surgical procedure.

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However, it’s entirely possible, depending on your health status, says pulmonologist Marie Budev, DO, Medical Director of Cleveland Clinic’s Lung Transplant Program.

“It’s not a person’s chronological age — the age on paper — but his or her physiological age that counts,” she says.

Aging more gracefully

While a lung transplant is not a cure, it can help with the symptoms of certain illnesses, such as chronic obstructive pulmonary disease (COPD).

Some lung transplant centers do consider those who are over age 65 too high a risk for a transplant.

However, there’s also a new trend among some transplant centers — especially centers with higher volumes. They are using transplanting with COPD or pulmonary fibrosis (IPF) well into their 70s with good results, Dr. Budev says.

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Several patients over age 75, including a 78-year-old patient, have received a lung transplant in recent years at Cleveland Clinic, she says.

Today, many people are living longer. As their life expectancy increases, many are also aging more gracefully. For some older adults, major procedures, like a lung transplant, are a viable option.

How do you know if you’re a candidate for a lung transplant?

A person’s birth date is easy to verify. But confirming your physiological age requires a complete screening and evaluation, Dr. Budev says.

This evaluation, which may take several visits, will include:

  • X-rays and CAT scans
  • Lab tests
  • Physical exam
  • Cardiac catheterization
  • Lung transplant team meeting

The team will want to see that you’re healthy enough and have no other problems other than your lungs to undergo a rigorous surgery and complete rehabilitation.

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If you have severe osteoporosis , cardiovascular issues, or are inactive, these are typically red flags. The team will consider signs of fragility: Are you exhausted, weak, confused or depressed?

The transplant team will also consider your social support system. Friends and family can be a big help before and after the surgery and in your rehabilitation.

How do older patients typically do after surgery?

Some older patients may have more complications and shorter survival rates, but that’s not always the case, Dr. Budev says. Your outcome, including recovery time, may not be any different than outcomes for those who are younger.

“It’s all very specific. There is no cookbook approach,” Dr. Budev says. “We have a 71-year-old running the country and we have 71-year-olds sitting in nursing homes. Age does not determine your outcome. It’s a multitude of factors.”

If you’re an older adult who has end-stage lung disease but is otherwise in fairly good health, it’s a good idea to explore your transplant options. The possibilities may surprise you.

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