Lung transplantation for chronic obstructive pulmonary disease at St Vincent's Hospital

Background: Lung transplantation (LTx) offers selected patients with end‐stage chronic obstructive pulmonary disease (COPD) an improved quality of life and possibly enhanced survival. Aim: To determine local outcomes of LTx for COPD we analysed 173 consecutive heart–LTx (n = 8), single LTx (SLTx; n ...

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Veröffentlicht in:Internal medicine journal 2006-01, Vol.36 (1), p.5-11
Hauptverfasser: Güneş, A., Aboyoun, C. L., Morton, J. M., Plit, M., Malouf, M. A., Glanville, A. R.
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container_end_page 11
container_issue 1
container_start_page 5
container_title Internal medicine journal
container_volume 36
creator Güneş, A.
Aboyoun, C. L.
Morton, J. M.
Plit, M.
Malouf, M. A.
Glanville, A. R.
description Background: Lung transplantation (LTx) offers selected patients with end‐stage chronic obstructive pulmonary disease (COPD) an improved quality of life and possibly enhanced survival. Aim: To determine local outcomes of LTx for COPD we analysed 173 consecutive heart–LTx (n = 8), single LTx (SLTx; n = 99) and bilateral LTx (BLTx; n = 66) carried out at a single institution during 1989–2003 for smoking‐related emphysema (E) (n = 112) and emphysema related to α‐1 antitrypsin deficiency (AATD) (n = 61). Methods: There were 98 men and 75 women with a mean age of 50 ± 6 years (standard deviation) (range 32–63 years). Median waiting time was 113 days (interquartile range (IQR) 50–230 days), and median inpatient stay was 13 days (IQR 9–21 days). Results: Perioperative survival (30 days) was 95% with deaths from sepsis (n = 5), cerebrovascular accident (n = 3) and multiorgan failure (n = 1). Mean follow‐up period was 1693 ± 1302 days (2–4805 days). The 1‐, 5‐ and 10‐year survivals (%) were similar for patients with E and AATD (P = 0.480 log rank) at 86 ± 5, 57 ± 7 and 31 ± 11, respectively, but 1‐ and 5‐year survivals for E were higher after BLTx than after SLTx (97 ± 2 and 81 ± 8 vs 85 ± 4 and 47 ± 6) (P = 0.015). Pretransplant body mass index, forced expiratory volume in 1 second, forced vital capacity, PaCO2, PaO2, six‐minute walk distance, home oxygen use, age, sex, cytomegalovirus donor–recipient mismatch, cardiopulmonary bypass use, year of transplant and ischaemic time did not influence survival after LTx. Increasing donor age was a survival risk factor for patients with E but not for those with AATD (hazard ratio 1.043; 95%confidence interval 1.014–1.025). Conclusion: Survival after LTx for COPD is similar to survival for other forms of solid organ transplantation, in part reflecting risk factor management.
doi_str_mv 10.1111/j.1445-5994.2006.01003.x
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Results: Perioperative survival (30 days) was 95% with deaths from sepsis (n = 5), cerebrovascular accident (n = 3) and multiorgan failure (n = 1). Mean follow‐up period was 1693 ± 1302 days (2–4805 days). The 1‐, 5‐ and 10‐year survivals (%) were similar for patients with E and AATD (P = 0.480 log rank) at 86 ± 5, 57 ± 7 and 31 ± 11, respectively, but 1‐ and 5‐year survivals for E were higher after BLTx than after SLTx (97 ± 2 and 81 ± 8 vs 85 ± 4 and 47 ± 6) (P = 0.015). Pretransplant body mass index, forced expiratory volume in 1 second, forced vital capacity, PaCO2, PaO2, six‐minute walk distance, home oxygen use, age, sex, cytomegalovirus donor–recipient mismatch, cardiopulmonary bypass use, year of transplant and ischaemic time did not influence survival after LTx. Increasing donor age was a survival risk factor for patients with E but not for those with AATD (hazard ratio 1.043; 95%confidence interval 1.014–1.025). 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L.</creatorcontrib><creatorcontrib>Morton, J. M.</creatorcontrib><creatorcontrib>Plit, M.</creatorcontrib><creatorcontrib>Malouf, M. A.</creatorcontrib><creatorcontrib>Glanville, A. R.</creatorcontrib><title>Lung transplantation for chronic obstructive pulmonary disease at St Vincent's Hospital</title><title>Internal medicine journal</title><addtitle>Intern Med J</addtitle><description>Background: Lung transplantation (LTx) offers selected patients with end‐stage chronic obstructive pulmonary disease (COPD) an improved quality of life and possibly enhanced survival. Aim: To determine local outcomes of LTx for COPD we analysed 173 consecutive heart–LTx (n = 8), single LTx (SLTx; n = 99) and bilateral LTx (BLTx; n = 66) carried out at a single institution during 1989–2003 for smoking‐related emphysema (E) (n = 112) and emphysema related to α‐1 antitrypsin deficiency (AATD) (n = 61). Methods: There were 98 men and 75 women with a mean age of 50 ± 6 years (standard deviation) (range 32–63 years). Median waiting time was 113 days (interquartile range (IQR) 50–230 days), and median inpatient stay was 13 days (IQR 9–21 days). Results: Perioperative survival (30 days) was 95% with deaths from sepsis (n = 5), cerebrovascular accident (n = 3) and multiorgan failure (n = 1). Mean follow‐up period was 1693 ± 1302 days (2–4805 days). The 1‐, 5‐ and 10‐year survivals (%) were similar for patients with E and AATD (P = 0.480 log rank) at 86 ± 5, 57 ± 7 and 31 ± 11, respectively, but 1‐ and 5‐year survivals for E were higher after BLTx than after SLTx (97 ± 2 and 81 ± 8 vs 85 ± 4 and 47 ± 6) (P = 0.015). Pretransplant body mass index, forced expiratory volume in 1 second, forced vital capacity, PaCO2, PaO2, six‐minute walk distance, home oxygen use, age, sex, cytomegalovirus donor–recipient mismatch, cardiopulmonary bypass use, year of transplant and ischaemic time did not influence survival after LTx. Increasing donor age was a survival risk factor for patients with E but not for those with AATD (hazard ratio 1.043; 95%confidence interval 1.014–1.025). 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L.</creatorcontrib><creatorcontrib>Morton, J. M.</creatorcontrib><creatorcontrib>Plit, M.</creatorcontrib><creatorcontrib>Malouf, M. A.</creatorcontrib><creatorcontrib>Glanville, A. R.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Internal medicine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Güneş, A.</au><au>Aboyoun, C. L.</au><au>Morton, J. M.</au><au>Plit, M.</au><au>Malouf, M. A.</au><au>Glanville, A. R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lung transplantation for chronic obstructive pulmonary disease at St Vincent's Hospital</atitle><jtitle>Internal medicine journal</jtitle><addtitle>Intern Med J</addtitle><date>2006-01</date><risdate>2006</risdate><volume>36</volume><issue>1</issue><spage>5</spage><epage>11</epage><pages>5-11</pages><issn>1444-0903</issn><eissn>1445-5994</eissn><abstract>Background: Lung transplantation (LTx) offers selected patients with end‐stage chronic obstructive pulmonary disease (COPD) an improved quality of life and possibly enhanced survival. Aim: To determine local outcomes of LTx for COPD we analysed 173 consecutive heart–LTx (n = 8), single LTx (SLTx; n = 99) and bilateral LTx (BLTx; n = 66) carried out at a single institution during 1989–2003 for smoking‐related emphysema (E) (n = 112) and emphysema related to α‐1 antitrypsin deficiency (AATD) (n = 61). Methods: There were 98 men and 75 women with a mean age of 50 ± 6 years (standard deviation) (range 32–63 years). Median waiting time was 113 days (interquartile range (IQR) 50–230 days), and median inpatient stay was 13 days (IQR 9–21 days). Results: Perioperative survival (30 days) was 95% with deaths from sepsis (n = 5), cerebrovascular accident (n = 3) and multiorgan failure (n = 1). Mean follow‐up period was 1693 ± 1302 days (2–4805 days). The 1‐, 5‐ and 10‐year survivals (%) were similar for patients with E and AATD (P = 0.480 log rank) at 86 ± 5, 57 ± 7 and 31 ± 11, respectively, but 1‐ and 5‐year survivals for E were higher after BLTx than after SLTx (97 ± 2 and 81 ± 8 vs 85 ± 4 and 47 ± 6) (P = 0.015). Pretransplant body mass index, forced expiratory volume in 1 second, forced vital capacity, PaCO2, PaO2, six‐minute walk distance, home oxygen use, age, sex, cytomegalovirus donor–recipient mismatch, cardiopulmonary bypass use, year of transplant and ischaemic time did not influence survival after LTx. Increasing donor age was a survival risk factor for patients with E but not for those with AATD (hazard ratio 1.043; 95%confidence interval 1.014–1.025). Conclusion: Survival after LTx for COPD is similar to survival for other forms of solid organ transplantation, in part reflecting risk factor management.</abstract><cop>Melbourne, Australia</cop><pub>Blackwell Science Pty</pub><pmid>16409307</pmid><doi>10.1111/j.1445-5994.2006.01003.x</doi><tpages>7</tpages></addata></record>
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subjects Biological and medical sciences
Cause of Death
Chronic obstructive pulmonary disease, asthma
COPD
Female
General aspects
Humans
lung transplant
Lung Transplantation - mortality
Male
Medical sciences
Middle Aged
Pneumology
Pneumonectomy
Proportional Hazards Models
Pulmonary Disease, Chronic Obstructive - mortality
Pulmonary Disease, Chronic Obstructive - surgery
Pulmonary Emphysema - surgery
Quality of Life
Severity of Illness Index
Survival Analysis
Treatment Outcome
title Lung transplantation for chronic obstructive pulmonary disease at St Vincent's Hospital
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