Date: Sunday, June 3, 2018
Session Name: Concurrent Session: Lung: From Allocation to Outcomes
Session Time: 2:30pm-4:00pm
Presentation Time: 3:18pm-3:30pm
Location: Room 303
Background: Severe heart diseases are traditionally considered a contraindication for Lung transplantation (LTx). There are suggestions that patients with severe heart diseases undergoing LTx will have lower survival and higher surgical morbidity and mortality than those without the heart diseases. Recently, we investigated the clinical outcomes of LTx patients with prior or simultaneous cardiac surgery (CS) in single center, and the results showed that patients who underwent LTx with previous CS had similar outcomes to patients undergoing isolated LTx. However, among the large nationwide population the difference in outcomes after LTx in patients with previous CS compared to those without has not been clear. The aim of this study is to compare the survival between patients who underwent CS prior to LTx and isolated LTx.
Methods: This study was a retrospective, matched-cohort analysis. Data was obtained from United Network of Organ Sharing database. Study population consists of all adult patients who underwent primary LTx from January 2001 to June 2016. The cohort included the patients that underwent CS prior to LTx (LTx + CS) during the study period. Survival outcomes of LTx + CS group were compared to a matched cohort of LTx recipients without cardiac surgery.
Results: In the study period, out of 31,885 adult patients who underwent LTx, 900 (2.8%) patients were identified as LTx + CS group. In 838 well matched pairs, 329 patients underwent prior coronary artery bypass graft (CABG), 40 patients had valve replacement/repair, and 11 had CABG + valve replacement/repair. LTx + CS group showed significantly worse survival (1y, 5y and 10y = 77.4%, 42.3% and 20.5%, respectively) than isolated LTx group (82.0%, 50.3% and 28.1%, p < 0.01) (Figure), hazard ratio of 1.27 (95%CI 1.10- 1.47, p < 0.01).
Conclusion: In this large cohort, LTx patients with prior CS had worse outcomes compared to patients who underwent isolated LTx. This result suggests that indication of LTx remain technically challenging for the patients who have history of prior CS, and may contribute to understand the clinical outcomes and effects of CS on LTx.
CITATION INFORMATION: Niikawa H., Okamoto T., Ayyat K., Itoda Y., McCurry K. Survival Rates of Patients with Previous Cardiac Surgery Undergoing Lung Transplant Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Niikawa H, Okamoto T, Ayyat K, Itoda Y, McCurry K. Survival Rates of Patients with Previous Cardiac Surgery Undergoing Lung Transplant [abstract]. https://atcmeetingabstracts.com/abstract/survival-rates-of-patients-with-previous-cardiac-surgery-undergoing-lung-transplant/. Accessed June 25, 2019.
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