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.