Lung transplant for interstitial lung disease: outcomes before and after implementation of the united network for organ sharing lung allocation scoring system. Eur J Cardiothorac Surg 2012 Mar;41(3):680-5
Date
01/06/2012Pubmed ID
22219404DOI
10.1093/ejcts/ezr079Scopus ID
2-s2.0-84861441530 (requires institutional sign-in at Scopus site) 7 CitationsAbstract
OBJECTIVES: This study was undertaken to evaluate whether the adoption of the united network for organ sharing lung allocation score (LAS) was associated with significant changes in lung transplantation (LTX) outcomes for patients with interstitial lung disease (ILD) who underwent LTX at the University of Wisconsin Hospital and Clinics.
METHODS: Outcomes for 107 consecutive patients with various forms of ILD who underwent LTX between January 1993 and March 2009 were examined. Patients transplanted following the implementation of the LAS system (LAS, n = 56) were compared with those transplanted prior to LAS implementation (pre-LAS, n = 51) for whom LAS scores were calculated.
RESULTS: Patients with idiopathic pulmonary fibrosis (IPF) comprised the majority of patients with ILD. Recipients transplanted after the implementation of the LAS were significantly older (pre-LAS: 50.4 vs. LAS: 56.7 years, P < 0.01), required more supplemental oxygen (3 vs. 5 l/min, P < 0.01) and displayed lower cardiac index values (3.1 vs. 2.6 l/m(2), P < 0.01). The estimated LAS was significantly increased from 38.3 (pre-LAS) to 43.3 (LAS), P < 0.01. However, waiting time decreased from 266 to 78 days (P < 0.01). The rate of bilateral vs. single LTX was lower (35 vs. 16%, P = 0.02) for the post-LAS group. Cold ischaemic time was shorter in the post-LAS group (434 vs. 299 min, P < 0.01), and the length of hospital stay decreased from 24 to 11 days (P < 0.01). Hospital mortality (11 vs. 7%, P = 0.51) and post-transplant survival did not differ between the groups.
CONCLUSIONS: Post-transplant outcomes for patients with ILD or the subset of recipients with IPF were not adversely affected by the implementation of the LAS.
Author List
De Oliveira NC, Osaki S, Maloney J, Cornwell RD, Meyer KCAuthor
Nilto De Oliveira MD Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultBronchoscopy
Female
Follow-Up Studies
Forced Expiratory Volume
Hemodynamics
Humans
Kaplan-Meier Estimate
Lung Diseases, Interstitial
Lung Transplantation
Male
Middle Aged
Organ Preservation
Patient Selection
Perioperative Care
Tissue and Organ Procurement
Treatment Outcome
Vital Capacity
Waiting Lists
Wisconsin