Transplantation: Outcomes in Lung Transplantation Slide |

Informing Patient Choices: Morbidity and Mortality 4 Years After Lung Transplantation for COPD FREE TO VIEW

Michael Cheng, MBBS; Allan Glanville
Author and Funding Information

St Vincent's Hospital, Sydney, NSW, Australia

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):1308A. doi:10.1016/j.chest.2016.08.1424
Text Size: A A A
Published online

SESSION TITLE: Outcomes in Lung Transplantation Slide

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Monday, October 24, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Severe COPD is one of the main indications for lung transplantation (LTX) with documented improvements in physiology, survival and quality of life. The aim of our study was to catalogue significant morbidities that developed within 4 years of LTX in order to inform patient discussions regarding likely outcomes after LTX.

METHODS: Retrospective single center study of 46 consecutive patients who underwent LTX for COPD 1st January 2009- 31st December 2011. Transplant assessment data were used to calculate BODE index score. Post-operative, 1 year and 4 year morbidity data were collected from patient files.

RESULTS: 34 patients had a BODE index ≥ 7. Mean age was 54.9 (39-66). Survival at 1 year was 93.5% (43/46) and at 4 years 71.7% (33/46). 6/12 patients ≥ 60 years old at transplant were deceased at 4 years but only 1 death occurred in 10 patients with alpha-1 anti-trypsin deficiency. Post-operatively, 45.7% (21/46) were discharged from acute hospital bed within 14 days; 82.6% within 30 days (38/46; and 17.4% (8/46) had length of stay beyond 30 days (range 8-178 days). 4 patients required ECMO post-operatively. At 4 years among survivors, 54.5% maintained BOS 0 or 0-P lung function (18/33); 10.9% BOS I; 10.9% BOS II; 10.9% BOS III. 41.3% (19/46) received treatment for antibody mediated rejection. 23.9% (11/46) had documented pulmonary embolism. 13.0% (6/46) required Nissen’s fundoplication for GORD and 57.6% (19/33) of patients alive at 4 years were on ≥ 3 classes of medications for GORD or had surgery. 1 patient required permanent hemodialysis; 23 developed stage 3 chronic kidney disease (CKD) at 1 year; 5 progressed to stage 4 CKD at 4 years. 15.2% (5/33) developed insulin dependent diabetes (DM) with a further 4 on oral hypoglycaemics (12.1%) at 4 years. Mean pill burden was 26 tablets (15-41) daily at 4 years. 12 patients took > 30 tablets.

CONCLUSIONS: LTX for COPD confers an excellent 4 year survival advantage. Significant morbidities at 4 years include pulmonary embolism, GORD, stage 4 CKD, DM and a significant daily tablet burden.

CLINICAL IMPLICATIONS: This information allows improved patient discussion to obtain informed consent for LTX.

DISCLOSURE: The following authors have nothing to disclose: Michael Cheng, Allan Glanville

No Product/Research Disclosure Information




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Airway complications after lung transplantation: Contemporary survival and outcomes. J Heart Lung Transplant Published online May 6, 2016;
Mesenchymal stem cells in the treatment of chronic lung disease. Respirology Published online Sep 29, 2016;
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543