help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by VIZZA, C. D.
Right arrow Articles by TRULOCK, E. P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by VIZZA, C. D.
Right arrow Articles by TRULOCK, E. P.

Am. J. Respir. Crit. Care Med., Volume 162, Number 3, September 2000, 819-825

Outcome of Patients with Cystic Fibrosis Awaiting Lung Transplantation

CARMINE DARIO VIZZA, ROGER D. YUSEN, JOHN P. LYNCH, FRANCESCO FEDELE, G. ALEXANDER PATTERSON, and ELBERT P. TRULOCK

Department of Cardiology; "La Sapienza" University School of Medicine, Rome, Italy; Washington University School of Medicine, St. Louis, Missouri

Cystic fibrosis is a common indication for lung transplantation. Under the current organ allocation system, donor lungs are distributed to patients based solely on their accrued waiting time, and the death rate on the waiting list has been high. Physiologic parameters have been used to guide the referral, but risk factors for death while awaiting transplantation have not been well defined. This study aimed to identify factors at the time of evaluation that were associated with death on the waiting list. A consecutive cohort of 146 patients with cystic fibrosis who were listed for lung transplantation was retrospectively reviewed. Characteristics of patients who died awaiting transplantation were compared with those of patients who survived until transplantation or the end of the study. Thirty-seven patients died while waiting, 76 underwent transplantation, and 33 were alive and still waiting. Actuarial survival rates for the entire cohort were 81% at 1 yr, 67% at 2 yr, and 59% at 3 yr. Although a multivariate Cox proportional hazards model (chi 2 = 29.6; p < 0.001) identified shorter six-minute walk distance (50 m increments; RR, 0.69; 95% CI, 0.57 to 0.84), higher systolic pulmonary artery pressure (5 mm Hg increments; RR, 1.41; 95% CI, 1.11 to 1.80), and diabetes mellitus (RR, 1.57; 95% CI, 1.06 to 2.32) as significant risk factors for death on the waiting list, these factors and other features overlapped considerably between the group of patients who died waiting and the group who lived until transplantation or the end of the study. The transplant evaluation selects a rather homogeneous cohort of patients for the waiting list. Unless outcome on the waiting list can be reliably predicted, establishing criteria to allocate donor lungs according to medical urgency may not be feasible.




This article has been cited by other articles:


Home page
 Eur. J. Cardiothorac. Surg.Home page
D. Shitrit, Y. Gershman, N. Peled, B. Medalion, M. Saute, A. Amital, and M. R. Kramer
Risk factors for death while awaiting lung transplantation in Israeli patients: 1997-2006.
Eur. J. Cardiothorac. Surg., August 1, 2008; 34(2): 444 - 448.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
D. Hadjiliadis
Special Considerations for Patients With Cystic Fibrosis Undergoing Lung Transplantation
Chest, April 1, 2007; 131(4): 1224 - 1231.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
E. P. Judge, J. D. Dodd, J. B. Masterson, and C. G. Gallagher
Pulmonary Abnormalities on High-Resolution CT Demonstrate More Rapid Decline Than FEV1 in Adults With Cystic Fibrosis.
Chest, November 1, 2006; 130(5): 1424 - 1432.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. A. Belkin, N. R. Henig, L. G. Singer, C. Chaparro, R. C. Rubenstein, S. X. Xie, J. Y. Yee, R. M. Kotloff, D. A. Lipson, and G. R. Bunin
Risk Factors for Death of Patients with Cystic Fibrosis Awaiting Lung Transplantation
Am. J. Respir. Crit. Care Med., March 15, 2006; 173(6): 659 - 666.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
T. M. Egan and R. M. Kotloff
Pro/Con Debate: Lung Allocation Should Be Based on Medical Urgency and Transplant Survival and Not on Waiting Time*
Chest, July 1, 2005; 128(1): 407 - 415.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
D. M. Rodman, J. M. Polis, S. L. Heltshe, M. K. Sontag, C. Chacon, R. V. Rodman, S. J. Brayshaw, G. A. Huitt, M. D. Iseman, M. T. Saavedra, et al.
Late Diagnosis Defines a Unique Population of Long-term Survivors of Cystic Fibrosis
Am. J. Respir. Crit. Care Med., March 15, 2005; 171(6): 621 - 626.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
S. D. Nathan
Lung Transplantation: Disease-Specific Considerations for Referral
Chest, March 1, 2005; 127(3): 1006 - 1016.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
A.R. Glanville and M. Estenne
Indications, patient selection and timing of referral for lung transplantation
Eur. Respir. J., November 1, 2003; 22(5): 845 - 852.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
S. M. Arcasoy, J. D. Christie, V. A. Ferrari, M. St. J. Sutton, D. A. Zisman, N. P. Blumenthal, A. Pochettino, and R. M. Kotloff
Echocardiographic Assessment of Pulmonary Hypertension in Patients with Advanced Lung Disease
Am. J. Respir. Crit. Care Med., March 1, 2003; 167(5): 735 - 740.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
P. G. Noone and T. M. Egan
Cystic Fibrosis: When to Refer for Lung Transplantation-Is the Answer Clear?
Am. J. Respir. Crit. Care Med., December 15, 2002; 166(12): 1531 - 1532.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
N. Mayer-Hamblett, M. Rosenfeld, J. Emerson, C. H. Goss, and M. L. Aitken
Developing Cystic Fibrosis Lung Transplant Referral Criteria Using Predictors of 2-Year Mortality
Am. J. Respir. Crit. Care Med., December 15, 2002; 166(12): 1550 - 1555.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
S. J. Timmer, A. M. Karamzadeh, G.L. Yung, J. Kriett, S. W. Jamieson, and C. M. Smith
Predicting Survival of Lung Transplantation Candidates With Idiopathic Interstitial Pneumonia* : Does PaO2 Predict Survival?
Chest, September 1, 2002; 122(3): 779 - 784.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
K. G. Tantisira, D. M. Systrom, and L. C. Ginns
An Elevated Breathing Reserve Index at the Lactate Threshold Is a Predictor of Mortality in Patients with Cystic Fibrosis Awaiting Lung Transplantation
Am. J. Respir. Crit. Care Med., June 15, 2002; 165(12): 1629 - 1633.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. TOBIN
Chronic Obstructive Pulmonary Disease, Pollution, Pulmonary Vascular Disease, Transplantation, Pleural Disease, and Lung Cancer in AJRCCM 2000
Am. J. Respir. Crit. Care Med., November 15, 2001; 164(10): 1789 - 1804.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. TOBIN
Pediatrics, Surfactant, and Cystic Fibrosis in AJRCCM 2000
Am. J. Respir. Crit. Care Med., November 1, 2001; 164(9): 1581 - 1594.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
K. Wallick, J. A. Nick, and D. M. Rodman
Cystic Fibrosis Critical Care . No Longer an Oxymoron
Am. J. Respir. Crit. Care Med., February 1, 2001; 163(2): 310 - 312.
[Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2000 American Thoracic Society 		  ATS State of the Art 2009