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Risk factors for death while awaiting lung transplantation in Israeli patients: 1997–2006

^a Pulmonary Institute, Rabin Medical Center, Beilinson Campus, Petah Tiqwa 49100, Israel
^b Cardiothoracic Department, Rabin Medical Center, Beilinson Campus, Petah Tiqwa 49100, Israel
^c Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Received 17 October 2007; received in revised form 29 February 2008; accepted 6 March 2008.

^_* Corresponding author. Tel.: +972 3 9377221; fax: +972 3 9377142. (Email: davids3{at}clalit.org.il).

Objective: Patients with end-stage lung disease very frequently die while awaiting lung transplantation. The aim of this study was to identify factors associated with mortality in patients referred for lung transplant assessment. Methods: The files of all consecutive patients listed for lung transplantation in Israel between 1997 and 2006 were reviewed and the data were compared statistically between those who survived to transplantation. Results: A total of 229 patients were listed for lung transplantation, of whom 42 (18.3%) died while awaiting transplantation. Comparison of the patients who survived to transplantation with those who did not using univariate analysis revealed that the died-waiting group was significantly older, used steroids to a greater extent, had more IPF patients and less emphysematous, and lower mean oxygen saturation at rest (p = 0.005). There were no between-group differences in comorbid diseases or pulmonary function measurements. The 6 min walk distance was strongly and inversely correlated with risk of death before transplantation (p = 0.005). On multivariate analysis, only oxygen saturation at rest was a significant independent risk factor for death while awaiting transplantation (OR 0.886; C.I. 0.805–0.974). Conclusions: There are several risk factors for death in the Israeli population listed for LTX, including age, steroid use, emphysematous patients and lower saturation at rest.

Abbreviations: LTX = lung transplantation • UNOS = United Network for Organ Sharing • 6MWD = six minute walk distance test • CPET = cardiopulmonary exercise test

Key Words: Lung transplantation: Waiting list: Emphysema • Pulmonary fibrosis • Mortality

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