RATIONALE: The association between a high predicted total lung capacity (pTLC) ratio (equal to pTLC(donor)/pTLC(recipient)), suggestive of an oversized allograft, with improved survival after lung transplantation (LTx) remains controversial. OBJECTIVES: To characterize donor-recipient lung size matching based on the pTLC ratio and to investigate the relationship of the pTLC ratio with post-LTx survival. METHODS: All subjects in the Scientific Registry of Transplant Recipients, who underwent first-time LTx in the lung allocation score-based system between May 4, 2005 and March 31, 2012, were studied, and the pTLC ratio was calculated on the basis of sex, height, and age. Risk of death after LTx was analyzed using Cox proportional hazards models. MEASUREMENTS AND MAIN RESULTS: The pTLC ratio was available for 10,289 of the 10,318 study subjects (99.7%). The mean pTLC ratio was 1.015 ± 0.175 (interquartile range, 0.918-1.119). Univariate analysis showed that the pTLC ratio was strongly associated with death in the first LTx year (P < 0.0001). With the pTLC ratio entered as a spline there was a nonlinear association with declining risk of death with higher pTLC ratio from 0.5 to about 1.3, where an inflection occurred with rising risk at higher values. Accounting for the pTLC ratio, recipient and donor sex were not independently associated with death after LTx. A change of pTLC ratio from 0.918 to 1.119 (the interquartile range) was associated with similar point estimates of reduced risk of death at 1 year in univariate (hazard ratio, 0.78) and comprehensive risk-adjusted multivariate models (hazard ratio, 0.86). CONCLUSIONS: The pTLC ratio is an independent predictor of death in the first year after LTx and explains the association of sex with survival after LTx. Incorporating the pTLC ratio in the lung allocation mechanism could improve outcomes after LTx.
RATIONALE: The association between a high predicted total lung capacity (pTLC) ratio (equal to pTLC(donor)/pTLC(recipient)), suggestive of an oversized allograft, with improved survival after lung transplantation (LTx) remains controversial. OBJECTIVES: To characterize donor-recipient lung size matching based on the pTLC ratio and to investigate the relationship of the pTLC ratio with post-LTx survival. METHODS: All subjects in the Scientific Registry of Transplant Recipients, who underwent first-time LTx in the lung allocation score-based system between May 4, 2005 and March 31, 2012, were studied, and the pTLC ratio was calculated on the basis of sex, height, and age. Risk of death after LTx was analyzed using Cox proportional hazards models. MEASUREMENTS AND MAIN RESULTS: The pTLC ratio was available for 10,289 of the 10,318 study subjects (99.7%). The mean pTLC ratio was 1.015 ± 0.175 (interquartile range, 0.918-1.119). Univariate analysis showed that the pTLC ratio was strongly associated with death in the first LTx year (P < 0.0001). With the pTLC ratio entered as a spline there was a nonlinear association with declining risk of death with higher pTLC ratio from 0.5 to about 1.3, where an inflection occurred with rising risk at higher values. Accounting for the pTLC ratio, recipient and donor sex were not independently associated with death after LTx. A change of pTLC ratio from 0.918 to 1.119 (the interquartile range) was associated with similar point estimates of reduced risk of death at 1 year in univariate (hazard ratio, 0.78) and comprehensive risk-adjusted multivariate models (hazard ratio, 0.86). CONCLUSIONS: The pTLC ratio is an independent predictor of death in the first year after LTx and explains the association of sex with survival after LTx. Incorporating the pTLC ratio in the lung allocation mechanism could improve outcomes after LTx.
Authors: Julia Klesney-Tait; Michael Eberlein; Lois Geist; John Keech; Joseph Zabner; Peter J Gruber; Mark D Iannettoni; Kalpaj Parekh Journal: Chest Date: 2015-05 Impact factor: 9.410
Authors: Hisham Taher; Christian Bauer; Eric Abston; David W Kaczka; Surya P Bhatt; Joseph Zabner; Roy G Brower; Reinhard R Beichel; Michael Eberlein Journal: J Appl Physiol (1985) Date: 2018-01-04
Authors: Jason M Gauthier; Andrew J Bierhals; Jingxia Liu; Keki R Balsara; Christine Frederiksen; Emily Gremminger; Ramsey R Hachem; Chad A Witt; Elbert P Trulock; Derek E Byers; Roger D Yusen; Patrick R Aguilar; Gary Marklin; Ruben G Nava; Benjamin D Kozower; Michael K Pasque; Bryan F Meyers; G Alexander Patterson; Daniel Kreisel; Varun Puri Journal: J Thorac Cardiovasc Surg Date: 2018-11-24 Impact factor: 5.209
Authors: Daniel C Chambers; Wida S Cherikh; Michael O Harhay; Don Hayes; Eileen Hsich; Kiran K Khush; Bruno Meiser; Luciano Potena; Joseph W Rossano; Alice E Toll; Tajinder P Singh; Aparna Sadavarte; Andreas Zuckermann; Josef Stehlik Journal: J Heart Lung Transplant Date: 2019-08-08 Impact factor: 10.247
Authors: Don Hayes; Wida S Cherikh; Daniel C Chambers; Michael O Harhay; Kiran K Khush; Rebecca R Lehman; Bruno Meiser; Joseph W Rossano; Eileen Hsich; Luciano Potena; Aparna Sadavarte; Tajinder P Singh; Andreas Zuckermann; Josef Stehlik Journal: J Heart Lung Transplant Date: 2019-08-08 Impact factor: 10.247