10 Year Survival After Lung Transplantation: A Single Center Experience

We evaluated long-term survival in lung transplant (tx) recipients who survived 10 years (y) or more from our institution to determine predictors to achieve long-term survival. Data was collected from the United Network for Organ Sharing (UNOS) registry database from a single institution. Inclusion criteria were: patients who received a lung tx between 1989-2005 and survived 10 years or more. Descriptive statistics were calculated and survival outcomes were analyzed utilizing the Kaplan-Meier method. Three hundred sixty-one (361) patients received a lung tx at our institution between 1989-2005, of which 77 patients survived at least 10y (21%). Diagnosis at the time of tx included: COPD/emphysema 45 (58.4%), idiopathic pulmonary fibrosis 12 (15.6%), alpha 1 anti-trypsin deficiency 6 (7.8%), cystic fibrosis 4 (5.2%) and others: including primary pulmonary hypertension and Eisenmeger’s syndrome. Seventy-four recipients (96.10%) were Caucasian; 46 (59.74%) were female. Age at time of tx ranged from 19-67 y (mean 50.8; median 52). Forced Expiratory Volume at 1 second (FEV1) prior to tx ranged from 11-97% (mean 35.8%; median 26%); Body Mass Index (BMI) prior to tx ranged from 14.7-35.6 kg/m2 (mean 23.7; median 23.9). Forty-two patients (54.5%) had a double lung tx; 35 (45.5%) had a single. Ischemic time ranged from 1.2-8.1 hours (mean 4.29; median 4.1). Survival ranged from 10.0 - 21.9 y (mean 15.5; median 15.48); Figure 1. The most recent BMI from follow-up through 10 years ranged from 14.5-39.5 kg/m2 (mean 25.9). Similarly, post tx FEV1 ranged from 29-120% (mean 69.8). Forty-two (54.5%) of our study population are currently alive; the most common cause of death included: chronic rejection (20%), and infection (17.14%). Successful long-term survival after lung transplantation is possible. In this patient population, on average the BMI after tx remained within the acceptable range for listing criteria, within our program guidelines. This may represent an important predictor for long-term survival.