Objective  To investigate the curative effect and prognosis of lung transplantation for patients over 65 years old with end-stage lung diseases.

  Methods  Clinical data of 24 elderly patients (≥65 years old) undergoing lung transplantation in Affiliated Wuxi People's Hospital of Nanjing Medical University from September 2002 to December 2011 were retrospectively analyzed. The survival conditions of elderly patients undergoing lung transplantation were studied and the survival conditions of unilateral lung transplantation and bilateral lung transplantation were compared. The complications after lung transplantation were observed and the death causes of patients died during the follow-up period was analyzed.

  Results  All patients completed the lung transplantation successfully. The 1, 3, 5 and 7-year cumulative survival rate of the 24 patients were respectively 75.0%, 62.5%, 33.3% and 12.5%, and those of patients undergoing unilateral lung transplantation were respectively 68.8%, 50.0%, 31.3% and 12.5% and those of the patients undergoing bilateral lung transplantation were respectively 87.5%, 87.5%, 37.5% and 12.5%. The median survival time of the patients undergoing unilateral lung transplantation and bilateral lung transplantation was respectively 35 months and 51 months, and there was no significant difference (P>0.05). The primary postoperative complication was infection with the incidence of 46% (11/24). Seventeen patients died during the long-term follow-up. Among them, 9 died of severe infection, 1 died of primary graft dysfunction (PGD), 1 died of acute rejection (AR), 4 died of bronchiolitis obliterans syndrome (BOS), 1 died of heart failure and 1 died of tumor.

  Conclusions  Unilateral lung transplantation and bilateral lung transplantation are both effective methods to treat elderly patients with end-stage lung diseases. Infection is the primary postoperative complication and the cause of death of elderly patients.