The Current Status of the Waiting-list Mortality at the New Lung Transplant Program in Tokyo: What Need to be Done in the Near Future?
- #TS/SUP 01-O-2
- Thoracic Surgery/Suppurative Lung Disease/Complications/ Other/Lung Transplantation
- Oral
The Current Status of the Waiting-list Mortality at the New Lung Transplant Program in Tokyo: What Need to be Done in the Near Future?
Masaki Anraku, Kentaro Kitano, Kazuhiro Nagayama, Jun-ichi Nitadori, Masaaki Sato, Jun Nakajima
The University of Tokyo Hospital, Tokyo, Japan
Date, time and location: 2018.05.25 10:30, Press Hall, 2F
Abstract
【Purpose】
We have
developed the lung transplant program in Tokyo since 2014. The deaths on the
waiting-list at our program were analyzed in association with various parameters
at the registration to determine contributing factors.
【Materials and Methods】
Cases registered
to the cadaveric lung transplant list at the Japan Organ Transplantation
Network between February 2014 and October 2017 were included into the study.
Data elements included for analyses were; lung disease, age, body mass index,
history of mechanical ventilation, diabetes, values from spirometry,
echocardiogram, and 6-minute walk test. Survival rates were calculated by
Kaplan-Meier method.
【Results】
A total
of 82 cases (35 with interstitial pneumonia/fibrosis, 19 with pulmonary
hypertension, 5 with emphysema, and 23 with other lung diseases) were included
in the study. The 1-year and 3-year survival rates on the waiting-list were
76.3% and 49.6%, respectively. The average waiting-time for transplant in 7
cases was 977 days. Factors associated to deaths on the list were; interstitial
pneumonia/fibrosis as primary lung disease (P=0.03), diabetes (P=0.02),
decreased %residual volume (P=0.03), decreased 6-minute walk distance
(P=0.004), and the lowest SpO2 at the test (P=0.04).
【Conclusions】
The
waiting list mortality at our center is crucially high. The evaluation process
needs to be optimized to include more of those who are able to maintain physical
activities of their daily life. Strategies to decrease the mortality while
keeping the patient activity improved need to be developed in the future.