Outcome of patients with end-stage pulmonary disease awaiting lung transplantation

Abstract

Objective To characterize the outcome of patients referral for lung transplantation at a single center,and to identify the prognosis factors for death while they are on the waiting list.Methods From January 2003 to January 2013,the clinical data of 83 patients with end-stage lung disease referral for lung transplantations consecutively in our center were analyzed retrospectively.Results Twenty-two patients (26.5％) died while waiting.Forty-one patients (49.4％) underwent lung transplantation,and 20 patients (24.1％) were still on the wait list.Compared to idiopathic pulmonary fibrosis (IPF) patients,the candidates with chronic obstructive pulmonary disease (COPD)had the higher chance of a transplantation (57.8％ vs.43.5％).However,patients with IPF had the higher probability of dying while waiting (39.1％ vs.15.6％,P =0.09).The mean waiting time was shorter (377.5 vs.181.7 days,P =0.016),and the mean pulmonary arterial pressure was lower (38.8 mmHg vs.54.3 mmHg,P =0.08) in the survival group than in the expired group.In the expired group,compared to other candidates,the mean survival time was shorter in patients with IPF than in other candidates (137.8 days vs.212.1 days,P =0.397).Those patients requiring the mechanical ventilation had the higher probability of dying while waiting (41.7％ vs.23.9％,P =0.287) than other patients.Conclusion The type of end-stage lung disease,pulmonary hypertension and mechanical ventilation may be distinctive prognosis factors for death on the lung transplantation wait list.When determining the lung allocation schemes,the type of disease and the medical urgency of transplantation should be taken into account together. Key words: Lung disease; Lung transplantation; Prognosis; Pulmonary fibrosis