Predicting Long Term Survival in Lung Transplant: Analysis of United Network for Organ Sharing (UNOS) Database

Purpose With the ISHLT registry the trends in mortality and morbidity are well described. However, there is significant heterogeneity in patient population undergoing transplant influencing the overall data. We aim to identify recipient related factors predicting long term survival in patient undergoing lung transplant and assess survival in setting of favorable factors. Methods We retrospectively reviewed the UNOS dataset for adult patients undergoing lung transplant between 1990 and 2017. Pertinent baseline characteristics, demographics, clinical parameters, and outcomes was performed. Primary end-point was patient survival time. Post-transplant survival was assessed using Kaplan-Meier and log rank tests. SPSS (version 24) was used for statistical testing. Results A total of 35483 patients with a underwent lung transplant during the review period. Median age was 56 years (range 18-81), with 55.7 % being male. Most common underlying conditions were COPD (n=9884; 28%), IPF (n=9594; 27.1%) and cystic fibrosis (n=4164; 11.2%). Overall median survival was 5.47 years (5.36- 5.58; CI=95%). Comparison of Kaplan-Meier curves showed better median survival with Age ≤65 yrs (5.6yrs vs 4.24yrs; p 60 (6.26yrs vs 5.25yrs; p 35) vs 5.19yr ( Conclusion Lung transplant survival is significantly influenced by recipient age, BMI, Functional status, need for mechanical ventilation or ECMO and history of previous transplants. Better patient selection can help improve long term outcomes from lung transplant.