I haven't used a piezo igniter on a wilderness trip. Guess I'm a bit 'old skool' with my Bic in my pocket (and spares tucked in everywhere).
I've had some piezo igniters that wouldn't quit. Some of the long-nose BBQ/fire lighters kept sparking (and starting the BBQ) long after the butane ran out. A couple of different ones got left out over winter, under snow and snowmelt. Just for laughs, I dried them out and scraped the rust off the 'points' and, voila, they sparked again.
I wonder if higher elevations (thin air) makes it harder to create a hot spark (which is basically a tiny plasma arc AFAIK). Perhaps the gap needs to be adjusted?
I've been told that it has to do with the density of the air at altitude, although I don't know for sure.
My observation is that different types of piezoelectric ignitions work at different altitudes. My Delta Windmill lighter quit somewhere in the 7000' range, but I've used the piezo ignition on my Jetboil at 10,000' just fine.
HJ