Impact of renal function on survival in idiopathic pulmonary fibrosis patients 65 years and older undergoing lung transplantation in the United States.

Objective: Changes in patient demographics, pharmacotherapies, and allocation systems have increased the number of patients receiving a lung transplant at an older age. This change reflects an increasing number of lung transplant recipients who have idiopathic pulmonary fibrosis. Methods: The United Network for Organ Sharing database was used to identify adult lung transplant recipients with and without a primary diagnosis of idiopathic pulmonary fibrosis from January 1, 2005, to March 31, 2025. Patient trends and 5-year survival were compared between idiopathic pulmonary fibrosis and non-idiopathic pulmonary fibrosis cohorts. A Cox proportional hazard multivariable regression model was used to adjust for 15 patient characteristics and identify significant predictors of survival. Results: Of 40,305 lung transplant recipients, 6786 (16.8%) had a primary diagnosis of idiopathic pulmonary fibrosis and were 65 years or older. Idiopathic pulmonary fibrosis patients aged 65 years and older made up 5% of the overall lung transplant population in 2005 and 23% in the first quarter of 2025 ( Conclusions: The proportion of patients with idiopathic pulmonary fibrosis aged 65 years or older has significantly increased in recent years. Impaired renal function in this population is associated with significantly worse clinical outcomes, warranting special consideration and risk stratification.