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

Publication ,  Journal Article
Vock, DM; Durheim, MT; Tsuang, WM; Finlen Copeland, CA; Tsiatis, AA; Davidian, M; Neely, ML; Lederer, DJ; Palmer, SM
Published in: Ann Am Thorac Soc
February 2017

RATIONALE: 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.

Duke Scholars

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Published In

Ann Am Thorac Soc

DOI

EISSN

2325-6621

Publication Date

February 2017

Volume

14

Issue

2

Start / End Page

172 / 181

Location

United States

Related Subject Headings

  • Young Adult
  • Waiting Lists
  • United States
  • Tissue and Organ Procurement
  • Tissue Donors
  • Time Factors
  • Survival Rate
  • Retrospective Studies
  • Registries
  • Patient Selection
 

Citation

APA
Chicago
ICMJE
MLA
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Vock, D. M., Durheim, M. T., Tsuang, W. M., Finlen Copeland, C. A., Tsiatis, A. A., Davidian, M., … Palmer, S. M. (2017). Survival Benefit of Lung Transplantation in the Modern Era of Lung Allocation. Ann Am Thorac Soc, 14(2), 172–181. https://doi.org/10.1513/AnnalsATS.201606-507OC
Vock, David M., Michael T. Durheim, Wayne M. Tsuang, C Ashley Finlen Copeland, Anastasios A. Tsiatis, Marie Davidian, Megan L. Neely, David J. Lederer, and Scott M. Palmer. “Survival Benefit of Lung Transplantation in the Modern Era of Lung Allocation.Ann Am Thorac Soc 14, no. 2 (February 2017): 172–81. https://doi.org/10.1513/AnnalsATS.201606-507OC.
Vock DM, Durheim MT, Tsuang WM, Finlen Copeland CA, Tsiatis AA, Davidian M, et al. Survival Benefit of Lung Transplantation in the Modern Era of Lung Allocation. Ann Am Thorac Soc. 2017 Feb;14(2):172–81.
Vock, David M., et al. “Survival Benefit of Lung Transplantation in the Modern Era of Lung Allocation.Ann Am Thorac Soc, vol. 14, no. 2, Feb. 2017, pp. 172–81. Pubmed, doi:10.1513/AnnalsATS.201606-507OC.
Vock DM, Durheim MT, Tsuang WM, Finlen Copeland CA, Tsiatis AA, Davidian M, Neely ML, Lederer DJ, Palmer SM. Survival Benefit of Lung Transplantation in the Modern Era of Lung Allocation. Ann Am Thorac Soc. 2017 Feb;14(2):172–181.

Published In

Ann Am Thorac Soc

DOI

EISSN

2325-6621

Publication Date

February 2017

Volume

14

Issue

2

Start / End Page

172 / 181

Location

United States

Related Subject Headings

  • Young Adult
  • Waiting Lists
  • United States
  • Tissue and Organ Procurement
  • Tissue Donors
  • Time Factors
  • Survival Rate
  • Retrospective Studies
  • Registries
  • Patient Selection