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Survival after bronchiolitis obliterans syndrome among bilateral lung transplant recipients.

Publication ,  Journal Article
Finlen Copeland, CA; Snyder, LD; Zaas, DW; Turbyfill, WJ; Davis, WA; Palmer, SM
Published in: Am J Respir Crit Care Med
September 15, 2010

RATIONALE: Despite the importance of bronchiolitis obliterans syndrome (BOS) in lung transplantation, little is known regarding the factors that influence survival after the onset of this condition, particularly among bilateral transplant recipients. OBJECTIVES: To identify factors that influence survival after the onset of BOS among bilateral lung transplant recipients. METHODS: The effect of demographic or clinical factors, occurring before BOS, upon survival after the onset of BOS was studied in 95 bilateral lung transplant recipient using Cox proportional hazards models. MEASUREMENTS AND MAIN RESULTS: Although many factors, including prior acute rejection or rejection treatments, were not associated with survival after BOS, BOS onset within 2 years of transplantation (early-onset BOS), or BOS onset grade of 2 or 3 (high-grade onset) were predictive of significantly worse survival (early onset P = 0.04; hazard ratio, 1.84; 95% confidence interval, 1.03-3.29; high-grade onset P = 0.003; hazard ratio, 2.40; 95% confidence interval, 1.34-4.32). The effects of both early onset and high-grade onset on survival persisted in multivariable analysis and after adjustment for concurrent treatments. Results suggested an interaction might exist between early onset and high-grade onset. In particular, high-grade onset of BOS, regardless of its timing after transplant, is associated with a very poor prognosis. CONCLUSIONS: The course of BOS after bilateral lung transplantation is variable. Distinct patterns of survival after BOS are evident and related to timing or severity of onset. Further characterization of these subgroups should provide a more rational basis from which to design, stratify, and assess response in future BOS treatment trials.

Duke Scholars

Published In

Am J Respir Crit Care Med

DOI

EISSN

1535-4970

Publication Date

September 15, 2010

Volume

182

Issue

6

Start / End Page

784 / 789

Location

United States

Related Subject Headings

  • Young Adult
  • Time Factors
  • Survival Analysis
  • Severity of Illness Index
  • Respiratory System
  • Proportional Hazards Models
  • Prognosis
  • Multivariate Analysis
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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Finlen Copeland, C. A., Snyder, L. D., Zaas, D. W., Turbyfill, W. J., Davis, W. A., & Palmer, S. M. (2010). Survival after bronchiolitis obliterans syndrome among bilateral lung transplant recipients. Am J Respir Crit Care Med, 182(6), 784–789. https://doi.org/10.1164/rccm.201002-0211OC
Finlen Copeland, C Ashley, Laurie D. Snyder, David W. Zaas, W Jackson Turbyfill, W Austin Davis, and Scott M. Palmer. “Survival after bronchiolitis obliterans syndrome among bilateral lung transplant recipients.Am J Respir Crit Care Med 182, no. 6 (September 15, 2010): 784–89. https://doi.org/10.1164/rccm.201002-0211OC.
Finlen Copeland CA, Snyder LD, Zaas DW, Turbyfill WJ, Davis WA, Palmer SM. Survival after bronchiolitis obliterans syndrome among bilateral lung transplant recipients. Am J Respir Crit Care Med. 2010 Sep 15;182(6):784–9.
Finlen Copeland, C. Ashley, et al. “Survival after bronchiolitis obliterans syndrome among bilateral lung transplant recipients.Am J Respir Crit Care Med, vol. 182, no. 6, Sept. 2010, pp. 784–89. Pubmed, doi:10.1164/rccm.201002-0211OC.
Finlen Copeland CA, Snyder LD, Zaas DW, Turbyfill WJ, Davis WA, Palmer SM. Survival after bronchiolitis obliterans syndrome among bilateral lung transplant recipients. Am J Respir Crit Care Med. 2010 Sep 15;182(6):784–789.

Published In

Am J Respir Crit Care Med

DOI

EISSN

1535-4970

Publication Date

September 15, 2010

Volume

182

Issue

6

Start / End Page

784 / 789

Location

United States

Related Subject Headings

  • Young Adult
  • Time Factors
  • Survival Analysis
  • Severity of Illness Index
  • Respiratory System
  • Proportional Hazards Models
  • Prognosis
  • Multivariate Analysis
  • Middle Aged
  • Male