Impact of Donor Arterial Partial Pressure of Oxygen on Outcomes After Lung Transplantation in Adult Cystic Fibrosis Recipients.
Donor PaO2 levels are used for assessing organs for lung transplantation (LTx), but survival implications of PaO2 levels in adult cystic fibrosis (CF) patients receiving LTx are unclear.



UNOS registry data spanning 2005-2013 were used to test for associations of donor PaO2 with patient survival and bronchiolitis obliterans syndrome (BOS) in adult (age ≥ 18 years) first-time LTx recipients diagnosed with CF.



The analysis included 1587 patients, of whom 1420 had complete data for multivariable Cox models. No statistically significant differences among donor PaO2 categories of ≤200, 201-300, 301-400, or >400 mmHg were found in univariate survival analysis (log-rank test p = 0.290). BOS onset did not significantly differ across donor PaO2 categories (Chi-square p = 0.480). Multivariable Cox models of patient survival supported the lack of difference across donor PaO2 categories. Interaction analysis found a modest difference in survival between the two top categories of donor PaO2 when examining patients with body mass index (BMI) in the lowest decile (≤16.5 kg/m(2)).



Donor PaO2 was not associated with survival or BOS onset in adult CF patients undergoing LTx. Notwithstanding statistically significant interactions between donor PaO2 and BMI, there was no evidence of post-LTx survival risk associated with donor PaO2 below conventional thresholds in any subgroup of adults with CF.
Departments of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH, 43205, USA. hayes.705@osu.edu.|Departments of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA. hayes.705@osu.edu.|Departments of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA. hayes.705@osu.edu.|Center for Epidemiology of Organ Failure and Transplantation, Nationwide Children's Hospital, Columbus, OH, USA. hayes.705@osu.edu.|Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH, USA. hayes.705@osu.edu.
Don
D
Hayes
Departments of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH, 43205, USA.|Center for Epidemiology of Organ Failure and Transplantation, Nationwide Children's Hospital, Columbus, OH, USA.|Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
Benjamin T
BT
Kopp
Departments of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH, 43205, USA.|Departments of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA.|Center for Epidemiology of Organ Failure and Transplantation, Nationwide Children's Hospital, Columbus, OH, USA.|Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
Stephen E
SE
Kirkby
Departments of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH, 43205, USA.|Center for Perinatal Research, Nationwide Children's Hospital, Columbus, OH, USA.
Susan D
SD
Reynolds
The University of Arizona-Tucson College of Pharmacy and College of Medicine, Tucson, AZ, USA.
Heidi M
HM
Mansour
Departments of Anesthesiology, The Ohio State University College of Medicine, Columbus, OH, USA.|Center for Epidemiology of Organ Failure and Transplantation, Nationwide Children's Hospital, Columbus, OH, USA.|Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
Joseph D
JD
Tobias
Departments of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH, 43205, USA.|Center for Epidemiology of Organ Failure and Transplantation, Nationwide Children's Hospital, Columbus, OH, USA.|Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
Dmitry
D
Tumin
D000328:Adult; D015992:Body Mass Index; D001989:Bronchiolitis Obliterans / Q000453:epidemiology* / Q000209:etiology; D003550:Cystic Fibrosis / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016040:Lung Transplantation / Q000009:adverse effects; D008297:Male; D010100:Oxygen / Q000097:blood*; D010313:Partial Pressure; D016016:Proportional Hazards Models; D012042:Registries; D015996:Survival Rate; D013577:Syndrome; D014019:Tissue Donors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult
D010100:Oxygen
Bronchiolitis obliterans syndrome; Cystic fibrosis; Donor; Lung transplantation; Partial pressure of oxygen; Survival