Purpose: Lung transplantation remains the final therapeutic option for patients with end stage lung disease. COPD being one of the most severe common lung diseases is the most frequent procuring cause for both single (43% of all single lung transplants) and double (32 % of all double lung transplants) in the UNOS database. We hypothesized that 6 minute walk test and FVC analysis would define the most severely affected COPD patients who might derive the most benefit from lung transplantation.

Methods: We queried the United Network for Organ Sharing (UNOS) thoracic dataset for patients older than 18 years who were on the wait list for lung transplantation, between 1987 and 2012. We identified 9,470 patients with a primary diagnosis of COPD from which 4164 had a documented 6 minute walk test. We compared survival from listing date between COPD patients with FVC< 50% predicted and 6 minute walk test<750 ft and others using Kaplan-Meier survival estimates and age-adjusted Cox Proportional Hazards Model. Survival time was censored at the time of transplantation, for patients who received a transplant.

Results: 914 patients had low 6MW distance (<750ft) and a low FVC (<50%), and their median survival was 1212 days. The age-adjusted hazard ratio (HR) for these patients was 3.07 (95% CI: 2.31-4.07, p<0.0001), compared to patients with high 6MW distance and high FVC (median survival 2230 days)(figure 1).

Conclusion: In conclusion, COPD patients with a 6 minute walk test less than 750ft and FVC less than 50% predicted may have the most to benefit from lung transplantation.

CITATION INFORMATION: Timofte I, Terrin M, Wijesinha M, Sanchez P, Pierson R, Barr E, Kim J, Kon Z, Pham S, Iacono A. 6 Minute Walk Test and FVC Analysis: A New Method to Prioritize Organ Allocation for Patients with COPD. Am J Transplant. 2016;16 (suppl 3).

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