Outcomes of Chinese Patients with End-stage Pulmonary Disease While Awaiting Lung Transplantation: A Single-center Study

Overview

Journal Chin Med J (Engl)

Specialty General Medicine

Date 2015 Dec 30

PMID 26712425

Citations 2

Authors

Wen-Xin He

Yu-Ling Yang

Yan Xia

Nan Song

Ming Liu

Peng Zhang

Jiang Fan

Ge-Ning Jiang

Affiliations

Soon will be listed here.

Abstract

Background: The factors affecting the outcome of patients referred for lung transplantation (LTx) still have not been investigated extensively. The aim of this study was to characterize the patient outcomes and identify the prognostic factors for death while awaiting the LTx.

Methods: From January 2003 to November 2013, the clinical data of 103 patients with end-stage lung disease that had been referred for LTx to Department of Thoracic Surgery, Shanghai Pulmonary Hospital were analyzed retrospectively. The relationship between predictors and survival was evaluated using the Kaplan-Meier method and the Cox proportional hazards model.

Results: Twenty-five patients (24.3%) died while awaiting the LTx. Fifty patients (48.5%) underwent LTx, and 28 patients (27.2%) were still on the waitlist. Compared to the candidates with chronic obstructive pulmonary disease (COPD), patients with idiopathic pulmonary fibrosis (IPF) had a higher mortality while awaiting the LTx (40.0% vs. 12.3%, P = 0.003). Patients requiring mechanical ventilation (MV) had a higher mortality while waiting than others (50.0% vs. 20.2%, P = 0.038). Two variables, using MV and IPF but not COPD as primary disease, emerged as significant independent risk factors for death on the waitlist (hazard ratio [HR] = 56.048, 95% confidence interval [CI]: 3.935-798.263, P = 0.003 and HR = 14.859, 95% CI: 2.695-81.932, P = 0.002, respectively).

Conclusion: The type of end-stage lung disease, pulmonary hypertension, and MV may be distinctive prognostic factors for death while awaiting the LTx.

Citing Articles

Sympatho-Vagal Dysfunction in Patients with End-Stage Lung Disease Awaiting Lung Transplantation.

Tobaldini E, Rodrigues G, Mantoan G, Monti A, Coti Zelati G, Cirelli C J Clin Med. 2020; 9(4).

PMID: 32316428 PMC: 7230240. DOI: 10.3390/jcm9041146.

Rituximab effect in severe progressive connective tissue disease-related lung disease: preliminary data.

Robles-Perez A, Dorca J, Castellvi I, Nolla J, Molina-Molina M, Narvaez J Rheumatol Int. 2020; 40(5):719-726.

PMID: 32157369 DOI: 10.1007/s00296-020-04545-0.

References

Huang J, Millis J, Mao Y, Millis M, Sang X, Zhong S . A pilot programme of organ donation after cardiac death in China. Lancet. 2011; 379(9818):862-5. DOI: 10.1016/S0140-6736(11)61086-6. View

. International guidelines for the selection of lung transplant candidates. The American Society for Transplant Physicians (ASTP)/American Thoracic Society(ATS)/European Respiratory Society(ERS)/International Society for Heart and Lung.... Am J Respir Crit Care Med. 1998; 158(1):335-9. DOI: 10.1164/ajrccm.158.1.15812. View

Belkin R, Henig N, Singer L, Chaparro C, Rubenstein R, Xie S . Risk factors for death of patients with cystic fibrosis awaiting lung transplantation. Am J Respir Crit Care Med. 2006; 173(6):659-66. PMC: 2662949. DOI: 10.1164/rccm.200410-1369OC. View

Orsini B, Sage E, Olland A, Cochet E, Tabutin M, Thumerel M . High-emergency waiting list for lung transplantation: early results of a nation-based study. Eur J Cardiothorac Surg. 2014; 46(3):e41-7. DOI: 10.1093/ejcts/ezu259. View

Egan T, Murray S, Bustami R, Shearon T, McCullough K, Edwards L . Development of the new lung allocation system in the United States. Am J Transplant. 2006; 6(5 Pt 2):1212-27. DOI: 10.1111/j.1600-6143.2006.01276.x. View

Reilly K, Gu D, Duan X, Wu X, Chen C, Huang J . Risk factors for chronic obstructive pulmonary disease mortality in Chinese adults. Am J Epidemiol. 2008; 167(8):998-1004. DOI: 10.1093/aje/kwm393. View

Garcia J, Iacono A, Kon Z, Griffith B . Ambulatory extracorporeal membrane oxygenation: a new approach for bridge-to-lung transplantation. J Thorac Cardiovasc Surg. 2010; 139(6):e137-9. DOI: 10.1016/j.jtcvs.2009.12.021. View

Shitrit D, Gershman Y, Peled N, Medalion B, Saute M, Amital A . Risk factors for death while awaiting lung transplantation in Israeli patients: 1997-2006. Eur J Cardiothorac Surg. 2008; 34(2):444-8. DOI: 10.1016/j.ejcts.2008.03.068. View

Chen L, Huang D, Mou X, Chen Y, Gong Y, He J . Investigation of quality of life and relevant influence factors in patients awaiting lung transplantation. J Thorac Dis. 2012; 3(4):244-8. PMC: 3256537. DOI: 10.3978/j.issn.2072-1439.2010.08.03. View

10.

Fadel E, Mercier O, Mussot S, Leroy-Ladurie F, Cerrina J, Chapelier A . Long-term outcome of double-lung and heart-lung transplantation for pulmonary hypertension: a comparative retrospective study of 219 patients. Eur J Cardiothorac Surg. 2010; 38(3):277-84. DOI: 10.1016/j.ejcts.2010.02.039. View

11.

Schmid C, Philipp A, Hilker M, Arlt M, Trabold B, Pfeiffer M . Bridge to lung transplantation through a pulmonary artery to left atrial oxygenator circuit. Ann Thorac Surg. 2008; 85(4):1202-5. DOI: 10.1016/j.athoracsur.2007.12.032. View

12.

Huang J, Wang H, Fan S, Zhao B, Zhang Z, Hao L . The national program for deceased organ donation in China. Transplantation. 2013; 96(1):5-9. DOI: 10.1097/TP.0b013e3182985491. View

13.

Barr M, Bourge R, Orens J, McCurry K, Ring W, Hulbert-Shearon T . Thoracic organ transplantation in the United States, 1994-2003. Am J Transplant. 2005; 5(4 Pt 2):934-49. DOI: 10.1111/j.1600-6135.2005.00836.x. View

14.

Zhong N, Wang C, Yao W, Chen P, Kang J, Huang S . Prevalence of chronic obstructive pulmonary disease in China: a large, population-based survey. Am J Respir Crit Care Med. 2007; 176(8):753-60. DOI: 10.1164/rccm.200612-1749OC. View

15.

Strueber M, Hoeper M, Fischer S, Cypel M, Warnecke G, Gottlieb J . Bridge to thoracic organ transplantation in patients with pulmonary arterial hypertension using a pumpless lung assist device. Am J Transplant. 2009; 9(4):853-7. DOI: 10.1111/j.1600-6143.2009.02549.x. View

16.

Huang J . Pragmatic solution for organ donation in response to challenges faced by the Chinese society: summary for the National Donation after Circulatory Death Pilot Program. Chin Med J (Engl). 2013; 126(3):569-73. View

17.

Mangi A, Mason D, Yun J, Murthy S, Pettersson G . Bridge to lung transplantation using short-term ambulatory extracorporeal membrane oxygenation. J Thorac Cardiovasc Surg. 2010; 140(3):713-5. DOI: 10.1016/j.jtcvs.2010.02.029. View

18.

Xin Y . [A case of human lung transplantation (author's transl)]. Zhonghua Wai Ke Za Zhi. 1979; 17(5):328-32. View

19.

Arcasoy S, Christie J, Pochettino A, Rosengard B, Blumenthal N, Bavaria J . Characteristics and outcomes of patients with sarcoidosis listed for lung transplantation. Chest. 2001; 120(3):873-80. DOI: 10.1378/chest.120.3.873. View