Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Oct;11(10):2197-204.
doi: 10.1111/j.1600-6143.2011.03684.x. Epub 2011 Aug 10.

The impact of pretransplant mechanical ventilation on short- and long-term survival after lung transplantation

J P Singer  1 , P D Blanc, C Hoopes, J A Golden, J L Koff, L E Leard, S Cheng, H Chen
Affiliations

The impact of pretransplant mechanical ventilation on short- and long-term survival after lung transplantation

J P Singer et al. Am J Transplant. 2011 Oct.

Abstract

Lung transplantation in mechanically ventilated (MV) patients has been associated with decreased posttransplant survival. Under the Lung Allocation Score (LAS) system, patients at greatest risk of death on the waiting list, particularly those requiring MV, are prioritized for lung allocation. We evaluated whether pretransplant MV is associated with poorer posttransplant survival in the LAS era. Using a national registry, we analyzed all adults undergoing lung transplantation in the United States from 2005 to 2010. Propensity scoring identified nonventilated matched referents for 419 subjects requiring MV at the time of transplantation. Survival was evaluated using Kaplan-Meier methods. Risk of death was estimated by hazard ratios employing time-dependent covariates. We found that pretransplant MV was associated with decreased overall survival after lung transplantation. In the first 6 months posttransplant, ventilated subjects had a twofold higher risk of death compared to nonventilated subjects. However, after 6 months posttransplant, survival did not differ by MV status. We also found that pretransplant MV was not associated with decreased survival in noncystic fibrosis obstructive lung diseases. These results suggest that under the LAS, pretransplant MV is associated with poorer short-term survival posttransplant. Notably, the increased risk of death appears to be strongest the early posttransplant period and limited to certain pretransplant diagnoses.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Figure 1
Figure 1
Figure 2
Figure 2
Figure 2
Figure 2
Figure 2
Figure 2
See this image and copyright information in PMC

References

    1. Christie JD, Edwards LB, Aurora P, Dobbels F, Kirk R, Rahmel AO, et al. The Registry of the International Society for Heart and Lung Transplantation: Twenty-sixth Official Adult Lung and Heart-Lung Transplantation Report-2009. J Heart Lung Transplant. 2009;28(10):1031–49. - PubMed
    1. Egan TM, Murray S, Bustami RT, Shearon TH, McCullough KP, Edwards LB, et al. Development of the new lung allocation system in the United States. Am J Transplant. 2006;6(5 Pt 2):1212–27. - PubMed
    1. Travaline JM, Cordova FC, Furukawa S, Criner GJ. Discrepancy between severity of lung impairment and seniority on the lung transplantation list. Transplant Proc. 2004;36(10):3156–60. - PubMed
    1. Elizur A, Sweet SC, Huddleston CB, Gandhi SK, Boslaugh SE, Kuklinski CA, et al. Pre-transplant mechanical ventilation increases short-term morbidity and mortality in pediatric patients with cystic fibrosis. J Heart Lung Transplant. 2007;26(2):127–31. - PubMed
    1. Flume PA, Egan TM, Westerman JH, Paradowski LJ, Yankaskas JR, Detterbeck FC, et al. Lung transplantation for mechanically ventilated patients. J Heart Lung Transplant. 1994;13(1 Pt 1):15–21. discussion 2-3. - PubMed

Publication types