Disease-specific survival benefit of lung transplantation in adults: a national cohort study

A Titman, CA Rogers, RS Bonser, NR Banner, LD Sharples

Research output: Contribution to journalArticle (Academic Journal)peer-review

68 Citations (Scopus)

Abstract

The lung transplantation candidate population is heterogeneous and survival benefit has not been established for all patient groups. UK data from a cohort of 1997 adult (aged > or = 16), first lung transplant candidates (listed July 1995 to July 2006, follow-up to December 2007) were analyzed by diagnosis, to assess mortality relative to continued listing. Donor lungs were primarily allocated according to local criteria. Diagnosis groups studied were cystic fibrosis (430), bronchiectasis (123), pulmonary hypertension (74), diffuse parenchymal lung disease (564), chronic obstructive pulmonary disease (COPD, 647) and other (159). The proportion of patients in each group who died while listed varied significantly (respectively 37%, 48%, 41%, 49%, 19%, 38%). All groups had an increased risk of death at transplant, which fell below waiting list risk of death within 4.3 months. Thereafter, the hazard ratio for death relative to listing ranged from 0.34 for cystic fibrosis to 0.64 for COPD (p <0.05 all groups except pulmonary hypertension). Mortality reduction was greater after bilateral lung transplantation in pulmonary fibrosis patients (p = 0.049), but not in COPD patients. Transplantation appeared to improve survival for all groups. Differential waiting list and posttransplant mortality by diagnosis suggest further use and development of algorithms to inform lung allocation.
Translated title of the contributionDisease-specific survival benefit of lung transplantation in adults: a national cohort study
Original languageEnglish
Pages (from-to)1640 - 1649
Number of pages10
JournalAmerican Journal of Transplantation
Volume9(7)
DOIs
Publication statusPublished - Jul 2009

Bibliographical note

Publisher: Wiley

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