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Use of Lung Transplantation Survival Models to Refine Patient Selection in Cystic Fibrosis

Summary: Use of Lung Transplantation Survival Models to
Refine Patient Selection in Cystic Fibrosis
Theodore G. Liou, Frederick R. Adler, and David Huang
Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, Department of Internal Medicine, and Departments of Biology
and Mathematics, University of Utah, Salt Lake City, Utah; and Neuropsychiatric Institute, University of California, Los Angeles, California
Lung transplantation in cystic fibrosis may improve survival for
patients with low 5-year predicted survival. Identifying characteris-
tics that affect post-transplantation survival may improve patient
selection and survival benefit. Using Cystic Fibrosis Foundation Pa-
tient Registry and United Network for Organ Sharing data, we
identified 845 lung transplant recipients from 1991­2001, and
12,826 control patients from 1997. We used Cox proportional haz-
ards models to identify variables that influence post-transplantation
survival. To estimate the survival benefit of transplantation for pa-
tients affected by identified variables, we compared Kaplan-Meier
survival curves of transplanted and control patients stratified by
5-year predicted survival. Post-transplantation survival improved
annually. Youth, Burkholderia cepacia, and cystic fibrosis­related ar-
thropathy increased the post-transplantation hazard of death.
Compared with control subjects, transplanted adults with a 5-year


Source: Adler, Fred - Department of Mathematics, University of Utah


Collections: Environmental Sciences and Ecology