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20 Year Survival Following Lung Transplantation

R. M. Reul, Jr1, S. Barrett1, A. Alnajar2, J. Dunson1, P. S. Garcha3, G. Loor4, J. A. Goss4, A. A. Rana4

1Office of Student Affairs, Baylor College of Medicine, Houston, TX, 2Department of Surgery, University of Miami Health System, Miami, FL, 3Department of Medicine, Baylor College of Medicine, Houston, TX, 4Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX

Meeting: 2021 American Transplant Congress

Abstract number: 433

Keywords: Lung transplantation, Outcome, Risk factors, Survival

Topic: Clinical Science » Lung » Lung: All Topics

Session Information

Session Name: Lung Transplant Topics

Session Type: Poster Video Chat

Date: Sunday, June 6, 2021

Session Time: 7:30pm-8:30pm

 Presentation Time: 7:40pm-7:50pm

Location: Virtual

*Purpose: Outcomes following lung transplantation (LTx) have been poor compared to those of heart, liver, and kidney transplants, with 5-year survival rates around 50%. To our knowledge, there has been no analysis on factors associated with extended survival past 20 years post-transplantation.

*Methods: All LTx cases performed between 1987 and 2000 within the United Network for Organ Sharing (UNOS) database were reviewed. Adult patients undergoing single or bilateral LTx who survived at least 1-year post-transplant were included. Demographic factors were compared between 1-20 year survivors and those surviving greater than 20 years using Student’s t-test (continuous) and Chi-square test (categorical). Kaplan-Meier and logistic regression analyses were performed to identify trends and risk factors associated with survival long-term survival. Cox regression analysis was then used to assess the impact of protective and risk factors on survival.

*Results: A total of 4,731 recipients were included in the analysis, including 311 recipient who lived greater than 20 years following transplantation. Factors associated with 20-year survival include recipient age 25-35 (OR 0.48-0.51), donor cause of death by head trauma (OR 0.70), female to female donor-recipient gender match (OR 0.74), diagnosis of COPD or Emphysema (OR 1.57), single lung transplant (OR 2.20), and recipient age 55-65 (OR 3.22). Cox regression risk factor analysis showed that patients with 1 or more protective factors were more likely (HR 0.88) to live to 20 years than patients with 1 or more risk factors (HR 1.30).

*Conclusions: The factors that lead to 20-year survival following LTx are different than those classically associated with shorter-term survival. Understanding the longer-term outcomes following LTx is important for all aspects of lung transplantation management, from pre- and post-operative management to donor allocation.

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20-Year Survival – Significant Factors on Multivariate Regression
Odds Ratio P value Confidence Interval
Recipient Age 25-35 0.48 0.000 0.32-0.72
Recipient Age 35-45 0.51 0.000 0.36-0.72
Recipient Age 55-65 3.22 0.000 1.88-5.51
COPD/Emphysema 1.57 0.022 1.07-2.30
Donor Head Trauma 0.70 0.005 0.54-0.90
Femaleto FemaleGenderMatch 0.74 0.030 0.56-0.97
Single Lung Transplant 2.30 0.000 1.55-3.10

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To cite this abstract in AMA style:

Reul RM, Barrett S, Alnajar A, Dunson J, Garcha PS, Loor G, Goss JA, Rana AA. 20 Year Survival Following Lung Transplantation [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/20-year-survival-following-lung-transplantation/. Accessed June 1, 2025.

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