Clinical lung and heart/lung transplantationLung Transplantation in Patients With Chronic Obstructive Pulmonary Disease in a National Cohort Is Without Obvious Survival Benefit
Section snippets
Subjects
In 1990, a program for lung transplantation was started at the Norwegian National Hospital, the only transplant center in Norway, and the hospital established a register with core information on all patients evaluated for lung transplantation. Patients selected for the lung transplantation waiting list fulfilled the following criteria, in line with international recommendations19: (1) terminal chronic pulmonary disease with respiratory failure or marked desaturation during exercise2; expected
Results
The patients accepted onto the waiting list had a mean age of 49 years (SD 10), and 55% were women. Of the transplantation candidates, 132 (60%) had COPD/emphysema (Table 1). The patients generally had low spirometry values, with a mean FEV1 of 0.8 liter (25% of predicted), low Pao2 values and BMI. Further descriptive statistics for the patients at the time of acceptance onto the waiting list are shown in Table 1. The median waiting time until transplantation for those actually transplanted (n
Discussion
In COPD/emphysema, there was no obvious survival benefit from BLT or SLT compared with no transplantation. In addition, in COPD/emphysema, there was little difference in survival with transplantation after 6 compared with 24 months of waiting. The finding of no survival benefit in patients with COPD/emphysema supports a previous report of no survival benefit during 2 years of observation,11 but is in contrast to other studies suggesting a survival benefit.14, 16
Our data suggest a survival
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