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Waiting List Mortality and Potential Risk Factors in Lung Transplant Candidates: A Single-Center Data.
Ertan Sarıbaş1, Ayse Nigar Halis1, Sevinc Citak2
1Department of Pulmonology, Kartal Kosuyolu High Specialization Education & Research Hospital, Istanbul, Türkiye.
Transplantation Proceedings
|October 23, 2025
Summary
Donor lung scarcity leads to long waits and high mortality for lung transplant candidates. Key risk factors like Major Idiopathic Interstitial Pneumonia and vascular disease impact survival, guiding better patient management.
Area of Science:
- Cardiology
- Pulmonology
- Transplant Surgery
Background:
- Lung transplantation is a critical treatment for end-stage lung disease.
- Limited donor lung availability creates significant waiting lists.
- Patient outcomes on the waiting list require careful evaluation.
Purpose of the Study:
- To assess survival durations for patients awaiting lung transplantation.
- To identify mortality risk factors in lung transplant candidates.
- To analyze waiting list mortality rates at a single center.
Main Methods:
- Retrospective analysis of 202 patients listed for lung transplantation (Jan 2017 - May 2023).
- Classification into diagnostic groups: Obstructive, Vascular, Suppurative, Major Idiopathic Interstitial Pneumonia (IIP), and Others.
- Survival analysis using Kaplan-Meier curves and Cox regression for risk factor identification.
Main Results:
- Overall waiting list mortality was 34.7%, with Major IIP patients having the highest rate (47.7%).
- Mortality predictors included shorter height, Major IIP/vascular disease diagnosis, elevated pulmonary artery systolic pressure (PAPs), low TAPSE/PAPs ratio, and high pulmonary vascular resistance (PVR).
- A PAPs ≥52 mmHg increased mortality risk 3.99-fold; vascular disease patients had the shortest survival (15.6 months).
Conclusions:
- Donor organ shortage significantly impacts lung transplant waiting times and patient mortality.
- Identifying mortality risks, particularly in Major IIP and vascular disease, is crucial.
- Optimizing listing strategies and clinical management can improve outcomes for lung transplant candidates.
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