title: Outcomes of Chinese Patients with End-stage Pulmonary Disease while Awaiting Lung Transplantation: A Single-center Study.
abstract: BACKGROUND
  The factors affecting the outcome of patients referred for lung transplantation (LTx) still have not been investigated extensively. The aim of this study was to characterize the patient outcomes and identify the prognostic factors for death while awaiting the LTx.
  
  
  METHODS
  From January 2003 to November 2013, the clinical data of 103 patients with end-stage lung disease that had been referred for LTx to Department of Thoracic Surgery, Shanghai Pulmonary Hospital were analyzed retrospectively. The relationship between predictors and survival was evaluated using the Kaplan-Meier method and the Cox proportional hazards model.
  
  
  RESULTS
  Twenty-five patients (24.3%) died while awaiting the LTx. Fifty patients (48.5%) underwent LTx, and 28 patients (27.2%) were still on the waitlist. Compared to the candidates with chronic obstructive pulmonary disease (COPD), patients with idiopathic pulmonary fibrosis (IPF) had a higher mortality while awaiting the LTx (40.0% vs. 12.3%, P = 0.003). Patients requiring mechanical ventilation (MV) had a higher mortality while waiting than others (50.0% vs. 20.2%, P = 0.038). Two variables, using MV and IPF but not COPD as primary disease, emerged as significant independent risk factors for death on the waitlist (hazard ratio [HR] = 56.048, 95% confidence interval [CI]: 3.935-798.263, P = 0.003 and HR = 14.859, 95% CI: 2.695-81.932, P = 0.002, respectively).
  
  
  CONCLUSIONS
  The type of end-stage lung disease, pulmonary hypertension, and MV may be distinctive prognostic factors for death while awaiting the LTx.
authors.forename: Wen-Xin
authors.initials: WX
authors.lastname: He
authors.forename: Yu-Ling
authors.initials: YL
authors.lastname: Yang
authors.forename: Yan
authors.initials: Y
authors.lastname: Xia
authors.forename: Nan
authors.initials: N
authors.lastname: Song
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
authors.forename: Peng
authors.initials: P
authors.lastname: Zhang
authors.forename: Jiang
authors.initials: J
authors.lastname: Fan
authors.affiliation: Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.
authors.forename: Ge-Ning
authors.initials: GN
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications; D054990:Idiopathic Pulmonary Fibrosis / Q000401:mortality; D008171:Lung Diseases / Q000401:mortality*; D016040:Lung Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality; D012189:Retrospective Studies; D014850:Waiting Lists