Age and Race Disparities Among Pediatric and Adult Cystic Fibrosis Lung Transplant Recipients.

H. Maredia, M. Bowring, A. Massie, S. Oyetunji, C. Merlo, R. Higgins, D. Segev, E. Bush.

JHU, Baltimore

Meeting: 2017 American Transplant Congress

Abstract number: B247

Keywords: Age factors, Lung, Mortality, Outcome

Session Information

Session Name: Poster Session B: Lung Transplantation Poster Session

Session Type: Poster Session

Date: Sunday, April 30, 2017

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall D1

Pediatric cystic fibrosis (CF) patients have a post-lung transplant survival disadvantage compared to adults. However, whether race and age are risk factors associated with post-transplant survival within the pediatric and adults groups is unknown.

METHODS: Using SRTR, we studied 1,531 transplant recipients diagnosed with CF and listed for transplantation from 5/1/2005-7/31/2015. Patients listed at multiple institutions were excluded. Cox regression was used to assess risk of death within pediatric (<18 years) and adult patients, after adjusting for recipient and donor characteristics as well as procedure type.

RESULTS: There were n=165 pediatric transplants and n=1,366 adult transplants. The median (IQR) age at transplant of pediatric and adult patients was 15 (14-17) and 30 (24-38), respectively. In the adjusted model, pediatric patients had a _1.161.54_2.05 times higher risk of death compared to adult transplant patients (p<0.01). Among pediatric recipients, we did not detect a statistically significant difference in risk of death by age (Figure, left; p=0.9) nor by race (aHR=_0.421.80_7.64; p=0.4).

However, among adults, African American (AA) recipients had a _1.052.04_3.97 times higher risk of death compared to non-AA recipients (p<0.05), but the disparity was no longer significant after controlling for age (p=0.08). There was a significant difference in risk of death by age group among adults (Figure, right; p<0.001). Recipients 61-80 years had a _2.115.02_11.9 times higher risk of death and recipients 18-30 years had a _1.412.00_2.83 times higher risk of death compared to recipients 41-60 years (both p<0.001). There was no significant difference in the risk of death between adult recipients aged 18-30 and pediatric recipients (aHR=_0.620.83_1.11; p=0.2).

CONCLUSIONS: The risk of mortality post-transplant varied based on age, but the association was not linear. The higher risk of mortality among pediatric, young adult, and oldest adult age group may be mediated by different biological and social characteristics that need to be further investigated in order to optimize post-transplant clinical management for patients.

CITATION INFORMATION: Maredia H, Bowring M, Massie A, Oyetunji S, Merlo C, Higgins R, Segev D, Bush E. Age and Race Disparities Among Pediatric and Adult Cystic Fibrosis Lung Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Maredia H, Bowring M, Massie A, Oyetunji S, Merlo C, Higgins R, Segev D, Bush E. Age and Race Disparities Among Pediatric and Adult Cystic Fibrosis Lung Transplant Recipients. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/age-and-race-disparities-among-pediatric-and-adult-cystic-fibrosis-lung-transplant-recipients/. Accessed November 25, 2024.

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