Analysis ofCystic Fibrosis Referrals for LungTransplantation

Patients withcystic fibrosis (CF) arebeing considered in increasing numbers ascandidates forlungtransplantation, despite earlier concerns that their nutritional statusandtheinfective nature oftheir lungdisease would contribute toincreased morbidity andmortality. We undertook aretrospective analysis ofpatients withCF referred forconsideration oflung transplant toidentify factors thathelped toselect suitable transplant candidatesandtoidentify characteristics thatpredicted death while onthewaiting list. Analysis of95referred patients withCFdemonstrated ahighrate ofsuitability(78%) byourcriteria. Themeanweight oflisted patients withCFwas77%predicted, andthemeanFEV1 was20%predicted. Sixteen percent oflisted patients Inthelast decade, lung transplantation hasemerged asareasonable therapy forpatients withendstage lung disease.' 2Patients with cystic fibrosis (CF) wereinitially considered forheart-lung transplant.3 Asexperience hasaccumulated withdouble lung transplant, this hasemerged asthepreferred procedureofforpatients withCF,particularly inNorth America.4-7 Thegrowing popularity oflungtransplantation andtherelative scarcity ofsuitable lung donors hasresulted inaprogressively longer waitfor potential lungtransplant recipients. Toaidinselection ofrecipients withCFforlung transplantation, Keremandothers8 fromtheUniversity ofToronto Cystic Fibrosis Center analyzed death intheir center. Using regression analysis, these authors identified theprobability ofdeath within 2 years fromavariety ofparameters oflung disease in patients withCF.8 These datamaybeuseful todetermine timing oflungtransplant referral. We performed a retrospective analysis ofall patients withCF whowerereferred toourlung