Retrospective Analysis of Lung Transplant Patients between 1991-2009: Improved Survival Is Related to Native Lung Disease
Y Li, Z Hu, J Gagermeier, C Alex, R Love, M Picken. Loyola Univ Med Ctr, Maywood, IL
Background: Survival of post lung transplantation (tx) patients has significantly improved consequent to modified therapies but there is a paucity of data regarding overall survival in different pre-tx diseases.
Design: We retrospectively reviewed 616 patients who underwent lung tx at a single lung tx center between 1991-2009. We evaluated survival rates chronologically (1991-00 and 2001-09) according to the primary pre-tx disease: cystic fibrosis (CF), pulmonary fibrosis (PF), α 1 antitrypsin deficiency/chronic obstructive pulmonary disease (AAT/COPD). Survival rates were compared in these three groups. Predicative survival curves were computed by life table analysis and differences between the three pre-tx diseases were analyzed by the generalized Wilcoxon test.
Results: Of the 616 lung tx patients, 111 had CF (18%), 246 had AAT/COPD(39%), and 135 had PF (22%). Recipients' mean age was 47.46 ± 13.66 years. The 1-, 3-, and 5-year survival rates in the AAT/COPD and PF groups were significantly increased (p<0.05) in the 2000s. However, there was no significant improvement in the 1-, 3- and 5-year survival rates for lung tx recipients with CF, even though these patients were younger. Mean age of patients with CF was 28.1±8.6 yrs, versus 55.6±6.8 in AAT/COPD and 53.3±10.3yrs in PF. This indicates that survival post lung tx is not dependent on age alone.The Wilcoxon test showed that before 2001, there was no significant difference in survival in the three groups, but, since 2000, recipients with AAT/COPD or PF had a higher survival rate than those with CF(p=0.001).
Conclusions: There was a significant increase in survival in AAT/COPD and PF; however, there has not been a significant improvement in the survival of patients with CF in last two decades. More studies are needed to ascertain the cause of this and to determine the optimal management regime for lung tx recipients.
Monday, March 22, 2010 9:30 AM
Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 238, Monday Morning