Psychosocial and Socioeconomic Factors Are Not Associated With Long-Term Survival After Lung Transplantation

The impact of psychosocial health and socioeconomic status (SES) on long-term lung transplant survival remains unclear.

We conducted a single-center, retrospective 2:1 matched case-control study of adult lung transplant recipients (1999-2019). Cases survived ≥6 years post-transplant; controls survived <6 years. Matching was based on transplant year (±5 years) and indication. Psychosocial health and SES were assessed using the Psychosocial Assessment of Candidates for Transplant (PACT) score, Mayo Clinic Housing-Based Socioeconomic Status (HOUSES) index, and Area Deprivation Index (ADI). Secondary covariates included insurance, marital status, employment, caregiver relationship, and proximity to the transplant center. Conditional logistic regression adjusted for age and gender was used.

Among 189 patients (63 cases, 126 controls), PACT score, HOUSES index, and ADI were not significantly associated with long-term survival. Patients with non-family caregivers had lower odds of survival compared to those with a spouse or partner (OR = 0.16, p = 0.022). Regional residents had lower odds of long-term survival compared to local recipients (OR = 0.55, p = 0.001).

Pre-transplant psychosocial and SES measures were not significantly associated with long-term survival. Caregiver relationships and geographic proximity may have a greater impact on outcomes, highlighting the importance of support systems and access to care.