Evolution of Recipient Characteristics Over 3 Decades and Impact on Survival After Lung Transplantation

Abstract

FIGURE 1. Number of bilateral and single LTx procedures per year over 3 decades. LTx, lung transplantation.

Health‐related quality of life and psychological indicators of thriving 15–19 years after heart or lung transplantation

“…Almost all patients in our sample (97%) were less than age 65 at transplant, and both age at transplant and age at follow‐up were only weakly associated with either physical or mental HRQOL (r's ≤.16, Table S1). Rather than age or the aging process, we suspect that the decline we observed in physical HRQOL, with 67% having clinically significant impairment at the follow‐up, reflects CTX patients’ growing medical burden in the long‐term years 13,16,20–25 . This is supported by our findings that, at follow‐up, patients hospitalized in the past year and those with greater dyspnea were more likely to be impaired.…”

“…Rather than age or the aging process, we suspect that the decline we observed in physical HRQOL, with 67% having clinically significant impairment at the follow-up, reflects CTX patients' growing medical burden in the long-term years. 13,16,[20][21][22][23][24][25] This is supported by our findings that, at follow-up, patients hospitalized in the past year and those with greater dyspnea were more likely to be impaired.…”

“…First, survival even to 15–20 years post‐CTX is no longer uncommon: worldwide survival rates are 38% at 15 years and 22% at 20 years among heart recipients, and 20% and 12%, respectively, in lung recipients 1,2 . Experienced centers report still higher rates 10‐20 . The literature on long‐term survivors focuses almost exclusively on describing their health status and identifying clinical and psychosocial prognostic factors for morbidity and mortality, 3,13,16,20–27 rather than considering HRQOL and its predictors.…”

“…1,2 Experienced centers report still higher rates. [10][11][12][13][14][15][16][17][18][19][20] The literature on long-term survivors focuses almost exclusively on describing their health status and identifying clinical and psychosocial prognostic factors for morbidity and mortality, 3,13,16,[20][21][22][23][24][25][26][27] rather than considering HRQOL and its predictors.…”

Cardiovascular Burden Is High in Pediatric Lung Transplant Recipients

“…However, major CV events only represent the endpoint of the CV disease continuum, 14 whereas earlier manifestations of CV disease, such as left ventricular hypertrophy, and important risk factors, such as CKD and arterial hypertension, do occur and can significantly affect outcome after LTx. 59,60 Our study aimed to highlight CV disease after pediatric LTx as an understudied subject and to advocate for more awareness thereof in clinical care. Further studies are warranted to investigate the effect of CV damage on graft function, whether improving CV health has a positive effect on overall survival, and to elucidate underlying mechanisms of CV disease (which may differ from other solid organ recipients) allowing the definition of treatment goals and strategies for this patient group.…”