Waiting time and mortality rate on lung transplant candidates in Japan: a single-center retrospective cohort study

Abstract Background As lung transplantation (LTX) is a valuable treatment procedure for end-stage pulmonary disease, delayed referral to a transplant center should be avoided. We aimed to conduct a single-center analysis of the survival time after listing for LTX and waitlist mortality in each disea...

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Autores principales:	Takashi Hirama, Miki Akiba, Tatsuaki Watanabe, Yui Watanabe, Hirotsugu Notsuda, Hisashi Oishi, Hiromichi Niikawa, Yoshinori Okada
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Lung transplantation Japan Organ Transplant Network Waiting time Mortality Japan Diseases of the respiratory system RC705-779
Acceso en línea:	https://doaj.org/article/16ec813a4810479a9d560315d217dc71
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spelling	oai:doaj.org-article:16ec813a4810479a9d560315d217dc712021-12-05T12:23:26ZWaiting time and mortality rate on lung transplant candidates in Japan: a single-center retrospective cohort study10.1186/s12890-021-01760-81471-2466https://doaj.org/article/16ec813a4810479a9d560315d217dc712021-11-01T00:00:00Zhttps://doi.org/10.1186/s12890-021-01760-8https://doaj.org/toc/1471-2466Abstract Background As lung transplantation (LTX) is a valuable treatment procedure for end-stage pulmonary disease, delayed referral to a transplant center should be avoided. We aimed to conduct a single-center analysis of the survival time after listing for LTX and waitlist mortality in each disease category in a Japanese population. Methods We included patients listed for LTX at Tohoku University Hospital from January 2007 to December 2020 who were followed up until March 2021. Pulmonary disease was categorized into the Obstructive, Vascular, Suppurative, Fibrosis, and Allogeneic groups. Risk factors for waitlist mortality were assessed using a Cox proportional hazards model. The Kaplan–Meier method was used to model time to death. Results We included 269 LTX candidates. Of those, 100, 72, and 97 patients were transplanted, waiting, and dead, respectively. The median time to LTX and time to death were 796 days (interquartile range [IQR] 579–1056) and 323 days (IQR 129–528), respectively. The Fibrosis group showed the highest mortality (50.9%; p < .001), followed by the Allogeneic (35.0%), Suppurative (33.3%), Vascular (32.1%), and Obstructive (13.1%) groups. The Fibrosis group showed a remarkable risk for waitlist mortality (hazard ratio 3.32, 95% CI 2.11–4.85). Conclusions In Japan, the waiting time is extremely long and candidates with Fibrosis have high mortality. There is a need to document outcomes based on the underlying disease for listed LTX candidates to help determine the optimal timing for listing patients based on the estimated local waiting time.Takashi HiramaMiki AkibaTatsuaki WatanabeYui WatanabeHirotsugu NotsudaHisashi OishiHiromichi NiikawaYoshinori OkadaBMCarticleLung transplantationJapan Organ Transplant NetworkWaiting timeMortalityJapanDiseases of the respiratory systemRC705-779ENBMC Pulmonary Medicine, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Lung transplantation Japan Organ Transplant Network Waiting time Mortality Japan Diseases of the respiratory system RC705-779
spellingShingle	Lung transplantation Japan Organ Transplant Network Waiting time Mortality Japan Diseases of the respiratory system RC705-779 Takashi Hirama Miki Akiba Tatsuaki Watanabe Yui Watanabe Hirotsugu Notsuda Hisashi Oishi Hiromichi Niikawa Yoshinori Okada Waiting time and mortality rate on lung transplant candidates in Japan: a single-center retrospective cohort study
description	Abstract Background As lung transplantation (LTX) is a valuable treatment procedure for end-stage pulmonary disease, delayed referral to a transplant center should be avoided. We aimed to conduct a single-center analysis of the survival time after listing for LTX and waitlist mortality in each disease category in a Japanese population. Methods We included patients listed for LTX at Tohoku University Hospital from January 2007 to December 2020 who were followed up until March 2021. Pulmonary disease was categorized into the Obstructive, Vascular, Suppurative, Fibrosis, and Allogeneic groups. Risk factors for waitlist mortality were assessed using a Cox proportional hazards model. The Kaplan–Meier method was used to model time to death. Results We included 269 LTX candidates. Of those, 100, 72, and 97 patients were transplanted, waiting, and dead, respectively. The median time to LTX and time to death were 796 days (interquartile range [IQR] 579–1056) and 323 days (IQR 129–528), respectively. The Fibrosis group showed the highest mortality (50.9%; p < .001), followed by the Allogeneic (35.0%), Suppurative (33.3%), Vascular (32.1%), and Obstructive (13.1%) groups. The Fibrosis group showed a remarkable risk for waitlist mortality (hazard ratio 3.32, 95% CI 2.11–4.85). Conclusions In Japan, the waiting time is extremely long and candidates with Fibrosis have high mortality. There is a need to document outcomes based on the underlying disease for listed LTX candidates to help determine the optimal timing for listing patients based on the estimated local waiting time.
format	article
author	Takashi Hirama Miki Akiba Tatsuaki Watanabe Yui Watanabe Hirotsugu Notsuda Hisashi Oishi Hiromichi Niikawa Yoshinori Okada
author_facet	Takashi Hirama Miki Akiba Tatsuaki Watanabe Yui Watanabe Hirotsugu Notsuda Hisashi Oishi Hiromichi Niikawa Yoshinori Okada
author_sort	Takashi Hirama
title	Waiting time and mortality rate on lung transplant candidates in Japan: a single-center retrospective cohort study
title_short	Waiting time and mortality rate on lung transplant candidates in Japan: a single-center retrospective cohort study
title_full	Waiting time and mortality rate on lung transplant candidates in Japan: a single-center retrospective cohort study
title_fullStr	Waiting time and mortality rate on lung transplant candidates in Japan: a single-center retrospective cohort study
title_full_unstemmed	Waiting time and mortality rate on lung transplant candidates in Japan: a single-center retrospective cohort study
title_sort	waiting time and mortality rate on lung transplant candidates in japan: a single-center retrospective cohort study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/16ec813a4810479a9d560315d217dc71
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Waiting time and mortality rate on lung transplant candidates in Japan: a single-center retrospective cohort study

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