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Risk factors associated with survival after lung transplant in iran
Fatemeh Sadat Hosseini Baharanchi1, Ebrahim Hajizadeh, Katayoun Najafizadeh
1From the Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Objectives:
Limited information is available about risk factors associated with survival after lung transplant in Iranian recipients. This study evaluated the effect of recipient and donor characteristics on survival after lung transplant.
Materials And Methods:
This retrospective study included 69 lung transplants (single, 31 patients [45%]; bilateral, 38 patients [55%]), from 2000 to 2013, at the National Research Institute of Tuberculosis and Lung Diseases, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. The Kaplan-Meier method was used to calculate survival, and variables were evaluated with multivariate analysis.
Results:
There were 54 male recipients (78%), and the most frequent indications for transplant included pulmonary fibrosis in 31 patients (45%) and bronchiectasis in 23 patients (33%). Recipient mean age was 36 ± 13 years and body mass index was 20 ± 4 kg/m2. Mean half-life (all recipients) was 2 ± 1 years and survival was 73% at 1 month, 67% at 1 year, and 40% at 5 years after transplant. For recipients who survived > 2 weeks after transplant half-life and survival were similar to previously international reported results. Recipient age, sex, type of transplant, body mass index, and pulmonary artery pressure were not associated with survival. Survival was significantly higher with recipient bronchiectasis, younger donors, and female donors.
Conclusions:
Survival after lung transplant was better with recipients who had bronchiectasis and donors that were younger or female. Patient selection, invasive monitoring, and supportive techniques such as extracorporeal membrane oxygenation for unstable patients during surgery may be helpful.