Gender, race, and age have been associated with health disparities, including in post-transplant outcomes. Given disparities in post-lung transplant outcomes are not well-understood, we assess whether there are demographic differences in risk of post-transplant mortality among recipients following the implementation of the lung allocation score (LAS).

METHODS: Using SRTR, we studied 9,625 adult lung transplant recipients from 5/1/2005-7/31/2015. Cox regression was used to compare hazard ratios by race (African American [AA] and non-African American [non-AA]), gender, and age (18-30, 31-40, 41-60 and 61-80) after adjusting for donor and recipient characteristics, as well as transplant procedure type and LAS.

RESULTS: Differences in risk of post-transplant mortality were statistically significant by gender and age categories (p<0.001) but not by race (p=0.2) (Figure). In the adjusted model, relative to recipients aged 41-60, recipients aged 18-30 and 61-81 years had 25% and 36% higher risk of mortality, respectively, while recipients aged 31-40 had 18% lower risk (Table). Relative to comparable male recipients, female recipients had 9% lower risk of death, while there was no significant difference between AA and non-AA recipients (p=0.8).

CONCLUSIONS: For a given LAS, women had lower risk of death and recipients aged 18-30 and 61-81 had higher risk of death relative to 41-60 year old recipients. Unlike liver and heart transplants, there was no significant difference by race in lung transplant outcomes. Age, which is taken into account in calculating LAS, may not be reflecting post-transplant outcomes accurately and may require adjustment. Identifying characteristics associated with mortality can allow for closer monitoring and prognostication of patients, and further investigation into potential biological mechanisms is warranted.

CITATION INFORMATION: Maredia H, Bowring M, Massie A, Oyetunji S, Merlo C, Higgins R, Segev D, Bush E. Age and Gender Disparities in Post-Lung Transplant Mortality. Am J Transplant. 2017;17 (suppl 3).

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