Assessment of survival benefit after lung transplantation by patient diagnosis

Charman, Susan C.; Sharples, Linda D.; McNeil, Keith; Wallwork, J.

doi:10.1016/s1053-2498(01)00352-7

Cited by 201 publications

(141 citation statements)

References 11 publications

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“…Comparison to other patients showed that the CF patients experienced fewer problems with mobility and sleep. This finding is in line with the results of previous studies regarding the influence of baseline diagnosis on HRQoL after transplantation 39, 40, 41, 42. Due to a lifetime of lung disease before LTx, the CF patients could not experience the “full” health that other groups of patients could have enjoyed in earlier stages of life.…”

Section: Discussionsupporting

confidence: 91%

Patient-reported health outcomes in long-term lung transplantation survivors: A prospective cohort study

Parizi

Krabbe

Verschuuren

et al. 2018

American Journal of Transplantation

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During the last three decades lung transplantation (LTx) has become a proven modality for increasing both survival and health‐related quality of life (HRQoL) in patients with various end‐stage lung diseases. Most previous studies have reported improved HRQoL shortly after LTx. With regard to long‐term effects on HRQoL, however, the evidence is less solid. This prospective cohort study was started with 828 patients who were on the waiting list for LTx. Then, in a longitudinal follow‐up, 370 post‐LTx patients were evaluated annually for up to 15 years. For all wait‐listed and follow‐up patients, the following four HRQoL instruments were administered: State‐Trait Anxiety Inventory, Zung Self‐rating Depression Scale, Nottingham Health Profile, and a visual analogue scale. Cross‐sectional and generalized estimating equation (GEE) analysis for repeated measures were performed to assess changes in HRQoL during follow‐up. After LTx, patients showed improvement in all HRQoL domains except pain, which remained steady throughout the long‐term follow‐up. The level of anxiety and depressive symptoms decreased significantly and remained constant. In conclusion, this study showed that HRQoL improves after LTx and tends to remain relatively constant for the entire life span.

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Section: Discussionsupporting

confidence: 91%

Patient-reported health outcomes in long-term lung transplantation survivors: A prospective cohort study

Parizi

Krabbe

Verschuuren

et al. 2018

American Journal of Transplantation

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“…We assumed that the log acceleration factor was linearly related to current LAS, LAS squared, native disease grouping, center volume over the preceding 2 years, recipient age, donor age greater than 55 years, donor smoking status, and difference in height greater than 0 between recipient and donor (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(32)(33)(34)(35). That is, these factors may moderate the effect of transplantation and increase or decrease the relative survival benefit on the multiplicative scale.…”

Section: Methodsmentioning

confidence: 99%

“…Single-center and registrybased studies (e.g., United Network for Organ Sharing [UNOS], Eurotransplant, and UK national registries) have arrived at varying and sometimes inconsistent conclusions on the efficacy of lung transplantation in adults (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). These studies are subject to several limitations.…”

mentioning

confidence: 99%

Survival Benefit of Lung Transplantation in the Modern Era of Lung Allocation

et al. 2017

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ORCID IDs: 0000-0002-5459-9579 (D.M.V.); 0000-0002-4186-5698 (M.T.D.). AbstractRationale: Lung transplantation is an accepted and increasingly employed treatment for advanced lung diseases, but the anticipated survival benefit of lung transplantation is poorly understood.Objectives: To determine whether and for which patients lung transplantation confers a survival benefit in the modern era of U.S. lung allocation.Methods: Data on 13,040 adults listed for lung transplantation between May 2005 and September 2011 were obtained from the United Network for Organ Sharing. A structural nested accelerated failure time model was used to model the survival benefit of lung transplantation over time. The effects of patient, donor, and transplant center characteristics on the relative survival benefit of transplantation were examined.Measurements and Main Results: Overall, 73.8% of transplant recipients were predicted to achieve a 2-year survival benefit with lung transplantation. The survival benefit of transplantation varied by native disease group (P = 0.062), with 2-year expected benefit in 39.2 and 98.9% of transplants occurring in those with obstructive lung disease and cystic fibrosis, respectively, and by lung allocation score at the time of transplantation (P , 0.001), with net 2-year benefit in only 6.8% of transplants occurring for lung allocation score less than 32.5 and in 99.9% of transplants for lung allocation score exceeding 40.Conclusions: A majority of adults undergoing transplantation experience a survival benefit, with the greatest potential benefit in those with higher lung allocation scores or restrictive native lung disease or cystic fibrosis. These results provide novel information to assess the expected benefit of lung transplantation at an individual level and to enhance lung allocation policy.

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“…Similar to the Eurotransplant system, and unlike the UNOS system in place for the UNOS, Hosenpud, and colleagues' study, the clinicians' assessment of medical urgency of patients in the UK Transplant system helped to determine prioritization for lung transplantation (31). Patients were categorized into pretransplant diagnostic categories of obstructive lung disease (n 5 163), pulmonary fibrosis (n 5 100), cystic fibrosis (n 5 174), bronchiectasis (n 5 51), and pulmonary hypertension (n 5 68).…”

Section: Literature Review Lung Transplantation: Survivalmentioning

confidence: 99%

Technology and Outcomes Assessment in Lung Transplantation

Yusen¹

2009

Proceedings of the American Thoracic Society

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Lung transplantation offers the hope of prolonged survival and significant improvement in quality of life to patients that have advanced lung diseases. However, the medical literature lacks strong positive evidence and shows conflicting information regarding survival and quality of life outcomes related to lung transplantation. Decisions about the use of lung transplantation require an assessment of trade-offs: do the potential health and quality of life benefits outweigh the potential risks and harms? No amount of theoretical reasoning can resolve this question; empiric data are needed. Rational analyses of these trade-offs require valid measurements of the benefits and harms to the patients in all relevant domains that affect survival and quality of life. Lung transplant systems and registries mainly focus outcomes assessment on patient survival on the waiting list and after transplantation. Improved analytic approaches allow comparisons of the survival effects of lung transplantation versus continued waiting. Lung transplant entities do not routinely collect quality of life data. However, the medical community and the public want to know how lung transplantation affects quality of life. Given the huge stakes for the patients, the providers, and the healthcare systems, key stakeholders need to further support quality of life assessment in patients with advanced lung disease that enter into the lung transplant systems. Studies of lung transplantation and its related technologies should assess patients with tools that integrate both survival and quality of life information. Higher quality information obtained will lead to improved knowledge and more informed decision making.

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Assessment of survival benefit after lung transplantation by patient diagnosis

Cited by 201 publications

References 11 publications

Patient-reported health outcomes in long-term lung transplantation survivors: A prospective cohort study

Patient-reported health outcomes in long-term lung transplantation survivors: A prospective cohort study

Survival Benefit of Lung Transplantation in the Modern Era of Lung Allocation

Technology and Outcomes Assessment in Lung Transplantation

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