Table 2.
Associations between lung preference and outcomes among 12,155 lung transplant candidates
| Outcome | Chronic Obstructive Pulmonary Disease |
Interstitial Lung Disease |
||||
|---|---|---|---|---|---|---|
| Restricted | Unrestricted | P Value | Restricted | Unrestricted | P Value | |
| Composite primary intention-to-treat outcome | ||||||
| No. listed | 2,634 | 2,044 | 3,596 | 3,881 | ||
| No. of events | 1,106 | 958 | 1,862 | 1,995 | ||
| Event rate (95% CI)* | 11.6 (10.9–12.3) | 12.3 (11.5–13.1) | 18.0 (17.2–18.8) | 17.5 (16.7–18.3) | ||
| Unadjusted hazard ratio (95% CI) | 1 | 0.94 (0.86–1.03) | 0.17 | 1 | 1.01 (0.94–1.07) | 0.87 |
| Adjusted hazard ratio (95% CI)† | 1 | 0.97 (0.89–1.07) | 0.60 | 1 | 1.01 (0.94–1.08) | 0.77 |
| Death on the waiting list or delisting‡ | ||||||
| No. of events | 321 | 179 | 728 | 591 | ||
| Event rate (95% CI)* | 11.9 (10.7–13.3) | 9.1 (7.8–10.5) | 41.0 (38.1–44.1) | 37.0 (34.2–40.1) | ||
| Unadjusted hazard ratio (95% CI) | 1 | 0.70 (0.59–0.84) | <0.001 | 1 | 0.73 (0.65–0.81) | <0.001 |
| Adjusted hazard ratio (95% CI)§ | 1 | 0.59 (0.47–0.73) | <0.001 | 1 | 0.79 (0.70–0.90) | <0.001 |
| Transplantation | ||||||
| No. undergoing transplant | 1,987 | 1,634 | 2,663 | 3,140 | ||
| Event rate (95% CI)* | 73.6 (70.4–76.9) | 82.6 (78.7–86.7) | 149.7 (144.1–155.5) | 196.8 (190.0–203.8) | ||
| Unadjusted hazard ratio (95% CI) | 1 | 1.13 (1.06–1.20) | <0.001 | 1 | 1.21 (1.15–1.28) | <0.001 |
| Adjusted hazard ratio (95% CI)§ | 1 | 1.33 (1.22–1.44) | <0.001 | 1 | 1.22 (1.14–1.30) | <0.001 |
| Graft failure at 1 yr | ||||||
| No. of events | 240 | 207 | 430 | 504 | ||
| Event rate (95% CI)* | 13.5 (11.8–15.2) | 14.1 (12.3–16.2) | 18.3 (16.7–20.1) | 18.1 (16.6–19.8) | ||
| Unadjusted hazard ratio | 1 | 1.01 (0.83–1.22) | 0.95 | 1 | 1.01 (0.88–1.15) | 0.93 |
| Fully adjusted hazard ratio|| | 1 | 1.00 (0.81–1.22) | 0.98 | 1 | 0.91 (0.79–1.05) | 0.19 |
| Graft failure at 5 yr | ||||||
| No. of events | 662 | 624 | 997 | 1,212 | ||
| Event rate (95% CI)* | 11.3 (10.5–12.2) | 12.9 (11.9–14.0) | 14.2 (13.4–15.0) | 18.3 (16.7–20.1) | ||
| Unadjusted hazard ratio | 1 | 1.14 (1.01–1.27) | 0.03 | 1 | 1.10 (1.01–1.20) | 0.04 |
| Fully adjusted hazard ratio|| | 1 | 1.10 (0.98–1.24) | 0.11 | 1 | 1.01 (0.92–1.11) | 0.89 |
Definition of abbreviation: CI = confidence interval.
Hazard ratios for secondary outcomes (death/delisting and transplantation) represent subdistribution hazard ratios from competing risks regression models.
Expressed as rate per 100 person-years.
Adjusted for lung allocation score at listing, ABO blood group, height, age, sex, race, body mass index at listing, with listing center as a random effect.
Death or delisting for clinical deterioration.
Adjusted for lung allocation score at listing, ABO blood group, height, age, sex, race, body mass index at listing, and listing center.
Adjusted for recipient characteristics at time of transplantation (lung allocation score, ABO blood group, height, age, sex, race, body mass index) and donor characteristics (age, body mass index, sex, height, alcohol use, history of cigarette use, pulmonary infection, diabetes, arterial oxygen pressure on 100% fraction of inspired oxygen), with listing center as a random effect.