Analysis of Patients Referred to a Lung Transplantation Unit

• Published in: Transplantation proceedings 2013-07, Vol.45 (6), p.2351-2356
• Main Authors: de Pablo, A, Juarros, L, Jodra, S, Pérez, V, López, E, González, O, Martín-de-Nicolos, J.L, Perez-cerdá, F, López-Encuentra, A, Benavides, P, Gamez, P
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Child; Comorbidity; Cross-Sectional Studies; Decision Support Techniques; Female; Health Status; Hospital Units; Humans; Interdisciplinary Communication; Life Style; Lung Diseases - diagnosis; Lung Diseases - surgery; Lung Transplantation - adverse effects; Male; Middle Aged; Patient Care Team; Patient Selection; Referral and Consultation; Residence Characteristics; Risk Assessment; Risk Factors; Severity of Illness Index; Spain; Surgery; Waiting Lists; Young Adult
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2013.02.132

Abstract This cross-sectional, concurrent and descriptive study presents the decisions regarding patients referred to our Lung Transplantation Unit (LTxU). Each patient is discussed in a multidisciplinary clinical session (phase I), rejecting some and accepting others for assessment in our LTxU (phase II) according to criteria of the National and International Guidelines for Transplantation. A protocol assessment in phase II, leads to a decision to reject, accept, or follow-up the candidate for LTx. Among 214 evaluation requests received in our unit from May 2008 to December 2011, 37 patients (17%) were rejected based on the information sent to our LTxU. Among the patients evaluated in phase II , 62 (28.9%) were put on the waiting list, 125 (58.4%) were rejected, and twenty-seven (12.6%) were postponed for future reconsideration, results that were similar to those described in the literature. The main disease referred for LTx was obstructive airflow (n = 98; 45.7%), followed by interstitial lung disease (ILD; n = 66; 30.8%), cystic fibrosis or bronchiectasis (n = 20; 9.3%), or primary pulmonary hypertension group 1 (n = 20; 9.3%). Ten patients (4.6%) were diagnosed with other respiratory diseases. Most patients (n = 165; 77.1%) lived in the region of our hospital (Madrid). The main reasons to reject patients for LTx were malnutrition, severe disease in other organs, toxic habits, and refusal of treatment. Finally, one out of four referred patients was accepted for LTx. In addition to serious comorbidities in various organs, a high percentage of patients who were not accepted for LTx because of these factors might have been of accepted had these conditions been corrected before patient referral.