Background
Methods
Patient population and study objectives
Statistical analysis
Results
Overall characteristics of LTX candidates at Tohoku University Hospital
Total | Obstructive | Vascular | Suppurative | Fibrosis | Allogeneic | p value | |
---|---|---|---|---|---|---|---|
n = 269 | n = 61 | n = 53 | n = 21 | n = 114 | n = 20 | ||
Age, median (IQR) | 44 (31–51) | 45 (37–49) | 28 (20–38) | 47 (39–50) | 48 (39–55) | 33 (21–47) | < .001 |
Sex, male (%) | 136 (50.6) | 17 (27.9) | 22 (41.5) | 11 (52.4) | 77 (53.5) | 9 (45.0) | 0.017 |
Body mass index (kg/m2), median (IQR) | 19.47 (16.89–23.51) | 18.66 (16.68–21.10) | 19.57 (17.73–23.50) | 18.82 (16.34–20.47) | 21.25 (17.19–25.70) | 15.90 (14.37–17.32) | < .001 |
Blood type, n (%) | 0.1875 | ||||||
A | 103 (38.3) | 30 (49.2) | 18 (33.9) | 5 (23.8) | 44 (38.6) | 6 (30.0) | |
O | 71 (26.4) | 12 (19.7) | 11 (20.8) | 10 (47.6) | 33 (28.9) | 5 (25.0) | |
B | 73 (27.1) | 17 (27.9) | 17 (32.1) | 5 (23.8) | 26 (22.8) | 8 (40.0) | |
AB | 22 (8.2) | 2 (3.3) | 7 (13.2) | 1 (4.7) | 11 (9.6) | 1 (5.0) | |
Pre-transplant condition, n (%) | |||||||
Malignancy | 26 (9.7) | 2 (3.3) | 0 (0.0) | 1 (4.8) | 10 (8.8) | 13 (65.0) | < .001 |
Connective tissue disorders | 47 (17.5) | 2 (3.3) | 5 (9.4) | 2 (9.5) | 35 (30.7) | 3 (15.0) | 0.175 |
Supplemental oxygen | 227 (84.4) | 51 (83.6) | 46 (86.8) | 19 (90.5) | 92 (80.7) | 19 (95.0) | 0.999 |
Pulmonary function, median (IQR) | |||||||
Predicted FVC (%) | 58.0 (40.9–80.8) | 80.7 (58.3–87.7) | 83.2 (71.0–94.9) | 48.3 (37.6–61.7) | 44.5 (30.4–59.7) | 43.4 (29.9–50.6) | < .001 |
6-min walk (m) | 300 (199–375) | 260 (187–343) | 386 (296–376) | 261 (187–338) | 288 (163–372) | 249 (168–345) | < .001 |
Estimated RVP (mmHg) | 38.0 (26.0–59.5) | 32.0 (26.0–42.0) | 89.5 (73.0–118.0) | 38.0 (20.0–61.0) | 34.0 (25.0–47.0) | 27.5 (22.0–39.5) | < .001 |
Laboratory, median (IQR) | |||||||
Hemoglobin (g/dL) | 13.6 (12.1–14.9) | 13.7 (13.0–14.8) | 13.3 (11.8–15.3) | 12.1 (11.6–14.6) | 13.7 (12.4–15.1) | 12.3 (11.1–14.6) | 0.127 |
Albumin (g/dL) | 3.9 (3.6–4.2) | 4.1 (3.9–4.3) | 4.2 (3.8–4.4) | 3.5 (3.2–3.8) | 3.8 (3.5–4.1) | 3.9 (3.6–4.0) | < .001 |
Creatinine (mg/dL) | 0.68 (0.57–0.79) | 0.62 (0.53–0.71) | 0.70 (0.60–0.80) | 0.60 (0.48–0.70) | 0.70 (0.59–0.83) | 0.55 (0.47–0.80) | 0.005 |
Outcomes, n (%) | < .001 | ||||||
Transplanted | 100 (37.2) | 33 (54.1) | 19 (35.8) | 11 (52.4) | 31 (27.2) | 6 (30.0) | |
Dead | 97 (36.1) | 8 (13.1) | 17 (32.1) | 7 (33.3) | 58 (50.9) | 7 (35.0) | |
Waiting (on March 2021) | 72 (26.8) | 20 (32.8) | 17 (32.1) | 3 (14.3) | 25 (21.9) | 7 (35.0) | |
Wait time, median day (IQR) | |||||||
Time to transplant (n = 100) | 796 (579–1056) | 981 (678–1132) | 959 (602–2015) | 758 (676–943) | 730 (331–849) | 730 (331–849) | 0.059 |
Time to death (n = 97) | 323 (129–528) | 599 (176–891) | 465 (201–897) | 196 (5–410) | 315 (113–513) | 287 (132–449) | 0.083 |
Time to events/censoring (n = 269) | 573 (283–991) | 930 (538–1193) | 959 (483–1804) | 685 (203–954) | 445 (16–641) | 403 (240–640) | < .001 |
Waitlist mortality in each disease category
Analysis of waitlist mortality and its risk factors in LTX candidates at Tohoku University Hospital
Univariate Cox model | Multivariate Cox model | |||||
---|---|---|---|---|---|---|
HR | 95% CI | p value | HR | 95% CI | p value | |
Fibrosis (vs. other groups) | 3.20 | 2.11–4.85 | 0.001 | 3.39 | 1.62–7.11 | 0.001 |
Age (every 1-year increase) | 1.03 | 1.01–1.05 | 0.001 | 1.04 | 1.01–1.07 | 0.006 |
Sex (male vs. female) | 2.20 | 1.45–3.33 | < .001 | 2.87 | 1.60–5.16 | < .001 |
BMI (every 1 kg/m2 increase) | 0.99 | 0.95–1.03 | 0.595 | 0.93 | 0.86–1.00 | 0.053 |
Connective tissue disorders (yes vs. no) | 1.00 | 0.58–1.74 | 0.992 | 0.71 | 0.35–1.47 | 0.360 |
Supplemental oxygen (yes vs. no) | 0.91 | 0.52–1.58 | 0.733 | 0.36 | 0.15–0.86 | 0.021 |
Predicted FVC (every 1% increase) | 0.98 | 0.97–0.99 | < .001 | 0.99 | 0.98–1.01 | 0.428 |
6-min walk distance (every 1 m increase) | 1.00 | 1.00–1.00 | 0.032 | 1.00 | 1.00–1.00 | 0.074 |
Estimated RVP (every 1 mmHg increase) | 1.00 | 0.99–1.01 | 0.996 | 1.02 | 1.01–1.02 | 0.002 |
Characteristics of LTX candidates with IPF and non-IPF ILD at Tohoku University Hospital
IPF (n = 57) | non-IPF ILD (n = 57) | p value | |
---|---|---|---|
Age, median (IQR) | 50 (44–56) | 47 (37–52) | 0.039 |
Sex, male (%) | 45 (78.9) | 32 (56.1) | 0.016 |
Body mass index (kg/m2), median (IQR) | 22.6 (18.8–26.2) | 19.8 (16.4–24.5) | 0.053 |
Pre-transplant condition, n (%) | |||
History of malignancy | 3 (5.3) | 7 (12.3) | 0.321 |
Connective tissue disorders | 2 (3.5) | 33 (57.9) | < .001 |
Supplemental oxygen | 44 (77.2) | 48 (84.2) | 0.476 |
Pulmonary function, median (IQR) | |||
Predicted FVC | 49.0 (32.9–64.9) | 43.7 (29.9–56.8) | 0.314 |
6 min walk (m) | 273 (138–369) | 300 (203–370) | 0.449 |
Estimated RVP (mmHg) | 34 (23–47) | 35 (25–47) | 0.849 |
Laboratory values, median (IQR) | |||
Hemoglobin (g/dL) | 14.0 (12.6–15.1) | 13.5 (12.3–15.0) | 0.399 |
Albumin (g/dL) | 3.8 (3.5–4.1) | 3.9 (3.6–4.1) | 0.444 |
Creatinine (mg/dL) | 0.72 (0.61–0.83) | 0.90 (0.55–0.81) | 0.116 |
Outcomes, n (%) | 0.039 | ||
Transplanted | 13 (22.8) | 18 (31.6) | |
Dead | 35 (61.4) | 23 (40.4) | |
Waiting (on March 2021) | 9 (15.8) | 16 (28.1) | |
Wait time, median day (IQR) | |||
Time to transplant (n = 13, 18) | 738 (291–913) | 651 (464–850) | 0.977 |
Time to death (n = 35, 23) | 278 (98–512) | 396 (122–514) | 0.623 |
Time to events/censoring (n = 57, 57) | 378 (160–572) | 495 (226–646) | 0.267 |
Analysis of waitlist mortality and its risk factors in LTX candidates with Fibrosis
Univariate Cox model | Multivariate Cox model | |||||
---|---|---|---|---|---|---|
HR | 95% CI | p value | HR | 95% CI | p value | |
IPF (vs. non-IPF ILD) | 1.72 | 1.02–2.92 | 0.043 | 1.98 | 1.11–3.55 | 0.022 |
Age (every 1-year increase) | 1.04 | 1.01–1.06 | 0.008 | 1.07 | 1.04–1.10 | < .001 |
Sex (male vs. female) | 4.17 | 2.36–7.37 | < .001 | 2.60 | 1.29–5.21 | 0.007 |
BMI (every 1 kg/m2 increase) | 1.00 | 0.95–1.05 | 0.856 | 0.91 | 0.84–0.98 | 0.016 |
Predicted FVC (every 1% increase) | 0.97 | 0.96–0.99 | < .001 | 0.97 | 0.95–0.99 | 0.009 |