Journal article
A Matched Survival Analysis of Lung Transplant Recipients with Covid-19-related Respiratory Failure
The annals of thoracic surgery, Vol.116(4), pp.819-828
10/2023
DOI: 10.1016/j.athoracsur.2022.09.039
PMCID: PMC9549709
PMID: 36228676
Abstract
BACKGROUND Lung transplantation is an acceptable and potentially life-saving treatment option for Covid-19-induced acute respiratory distress syndrome and pulmonary fibrosis. The objective of this study is to determine whether recipients of lung transplantation (LT) for Covid-19-related lung disease have comparable outcomes to other recipients with a similar level of lung dysfunction. METHODS The Organ Procurement and Transplant Network database was queried for adult LT candidates between 2006 and 2021. Recipients with Covid-19-related respiratory failure were matched 1:2 using a nearest neighbor algorithm. Kaplan-Meier methods with log-rank tests were used to compare long-term survival. A proportional hazards model was used to calculate risk-adjusted mortality. RESULTS 37,333 LT candidates from all causes were compared to 334 candidates from Covid-19-related respiratory failure. Covid-19 recipients were more likely to be younger (50 vs. 57 years, P<0.001), male (79% vs. 60%, P<0.001), require extracorporeal membrane oxygenation (ECMO) (56.3% vs. 4.0%, P<0.001), and have worse lung function (lung allocation score 82.4 vs 47.8, P<0.001) at transplantation. Subsequently, 227 Covid-19 recipients were matched with 454 controls. Patients transplanted for Covid-19 had similar rates of mechanical ventilation, ECMO, postoperative complications, and functional status at discharge compared with controls. There was no difference in overall survival or risk-adjusted mortality from Covid-19 (hazard ratio 0,82, 95% confidence interval 0.45-1.53, P=0.54). CONCLUSIONS Six-month survival for recipients of LT for Covid-19-related respiratory failure was comparable to that of other lung transplantation recipients.
Details
- Title: Subtitle
- A Matched Survival Analysis of Lung Transplant Recipients with Covid-19-related Respiratory Failure
- Creators
- Kyle FreischlagThomas J LynchVitaly IevlevCaitlyn GriesJohn C KeechEvgeny V ArshavaTahuanty PenaJulia A Klesney-TaitKalpaj R Parekh
- Resource Type
- Journal article
- Publication Details
- The annals of thoracic surgery, Vol.116(4), pp.819-828
- DOI
- 10.1016/j.athoracsur.2022.09.039
- PMID
- 36228676
- PMCID
- PMC9549709
- ISSN
- 0003-4975
- eISSN
- 1552-6259
- Grant note
- DOI: 10.13039/100000002, name: NIH
- Language
- English
- Electronic publication date
- 10/10/2022
- Date published
- 10/2023
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Anatomy and Cell Biology; Stead Family Department of Pediatrics; Cardiothoracic Surgery; Internal Medicine
- Record Identifier
- 9984306059902771
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