Adolescent CF Lung Transplant Recipients Have Decreased Survival When Compared to CF Lung Transplant Recipients in Other Age Groups

Abstract

Purpose Lung transplant (LTRX) is a treatment for end-stage cystic fibrosis (CF) lung disease. CF is the leading indication for LTRX in children (6-11) and adolescents (12-17) accounting for 56% and 72% of all transplants, respectively. The half-life of adult recipients was 5.4 years compared with 5.5 years in pediatric recipients. We hypothesize that there is a difference in survival of patients with CF based on age of recipient. Methods and Materials This study was a retrospective analysis of the UNOS Database for all LTRX recipients with CF performed in the United States from October 1999 to June 2011. Patients were grouped on the basis of age into 4 groups [children (age 6-12), adolescents (age 13-18), young adults (age 19-30), and older adults (age 31-50)]. The primary outcome of interest was patient survival. Results There were 3,302 LTRX performed in CF patients ages of 6-50 years; 143 (4%) in children, 461 (14%) in adolescents, 1,568 (48%) in young adults, and 1130 (34%) in older adults with follow-up data available for 99%. Adolescents were more likely to be female, have lower creatinine level, have shorter wait list time and donor ischemic time compared to adults (p Conclusions Adolescents comprise a minority of CF patients that undergo LTRX in the United States and have the lowest overall survival. Older adults have graft survival and patient survival that is over twice as long as adolescents. The decreased survival observed in adolescents is independent of some donor and recipient characteristics. Further study is needed to improve outcomes in this high risk group of patients.