Exercise testing in pediatric lung transplant candidates with cystic fibrosis

Exercise testing is considered an important prognostic tool for the selection of pediatric lung transplant candidates with end-stage CF lung disease. To better understand the current practice as it pertains to exercise testing, a self-administered questionnaire was distributed to 25 pediatric lung transplant centers within the IPLTC across Australia, Europe, and North America. All centers perform standardized exercise tests. Fifteen centers perform one single-field test (6MWT/12MWT), while seven perform a six-min walk plus an additional test: SWT (N = 1), 3MST (N = 1), and CPET (N = 5). Frequency of testing is markedly different among centers. Two centers conduct exercise testing once, all others at multiple time points. Equipment availability and cost were no limitations, but lack of time (20%) and personnel (16%), and paucity of prognostic evidence (16%) and reference values (12%) were stated. Exercise testing is considered important and extensively used in the evaluation of pediatric lung transplant candidates with CF; methods of exercise test and the frequency of testing vary widely. We propose a prospective multicenter study to evaluate the efficacy of exercise testing and its prognostic value using a standardized protocol.