Status of lung transplant recipients surviving beyond five years.
BACKGROUND
Prolonged survival after lung transplantation is now commonplace as a result of advances in surgical techniques and postoperative management protocols. Although 1- and 5-year functional and survival data after lung transplantation are well known, sparse information is available regarding functional status of recipients surviving beyond 5 years.


METHODS
The medical records and pulmonary function study results of lung transplant recipients who had survived at least 5 years as of September 1995 were retrospectively reviewed.


RESULTS
Of the 76 transplantations performed between November 1983 and September 1990, 30 (39.5%) were double lung transplantations, and 46 (60.5%) were single lung transplantations. Thirty-one recipients were alive 5 years after transplantation (12 double lung transplantations, 19 single lung transplantations). The 5-, 6-, and 7-year survival rates were 44%, 34%, and 29%, respectively. There was no association or difference in cytomegalovirus status, sex, and blood group between those who died within 5 years and those who survived beyond 5 years. The median percent predicted FEVs for single and double lung transplant recipients were as follows: 5 yrs-75%, 75%; 6 years-73%, 75%; 7 years-68%, 73%. The proportion of recipients with bronchiolitis obliterans syndrome according to published criteria was as follows: stage 0, 32%; stage I, 19%; stage II, 16%; and stage III, 19%. The functional status (i.e., active, working, disabled) 5 years after transplantation was as follows: active/working, 74%; active but not working, 13%; some limitation/independent, 10%; and disabled, 3%.


CONCLUSIONS
Bronchiolitis obliterans syndrome is a frequent occurrence in long-term survivors. Nevertheless, in spite of this condition, most recipients have acceptable lung function, are active, and are generally working.
Chaparro
C
C
Department of Medicine, The Toronto Hospital, Ontario, Canada.
Scavuzzo
M
M
Winton
T
T
Keshavjee
S
S
Kesten
S
S
D000203:Activities of Daily Living; D000328:Adult; D001989:Bronchiolitis Obliterans / Q000209:etiology; D006233:Persons with Disabilities; D004651:Employment; D005260:Female; D005541:Forced Expiratory Volume; D006304:Health Status; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011653:Pulmonary Diffusing Capacity; D012189:Retrospective Studies; D016019:Survival Analysis; D014797:Vital Capacity