Journal of Transplantation

Research Article

Lung Transplantation in Patients with High Lung Allocation Scores in the US: Evidence for the Need to Evaluate Score Specific Outcomes

Table 3

Predictors of 5-year mortality after lung transplant.


Recipient demographic factors	Unadjusted		Adjusted
Recipient demographic factors	Hazard ratio (95% CI)	value	Hazard ratio (95% CI)	value

LAS
Quartile 1 (26.3–34.5)	Reference (1)		Reference (1)
Quartile 2 (34.6–39.3)	1.07 (0.97–1.18)	0.17	1.13 (1.01–1.26)	0.03
Quartile 3 (39.4–48.6)	1.11 (1.01–1.22)	0.04	1.17 (1.04–1.32)	0.01
Quartile 4 (48.7–95.7)	1.30 (1.18–1.44)	<0.001	1.17 (1.02–1.33)	0.02
Age, years	1.01 (1.00–1.01)	<0.001	1.01 (1.01–1.02)	<0.001
Male gender	1.11 (1.04–1.19)	0.004	1.10 (1.02–1.18)	0.01
Race, (%)
White	Reference (1)		Reference (1)
Black	0.98 (0.86–1.11)	0.70	1.05 (0.92–1.19)	0.48
Hispanic	1.01 (0.87–1.18)	0.87	1.03 (0.88–1.21)	0.72
Asian	0.94 (0.73–1.21)	0.64	0.94 (0.72–1.21)	0.62
BMI
Normal weight 18–24.9 kg/m²	Reference (1)		Reference (1)
Underweight <18 kg/m²	1.18 (1.04–1.33)	0.01	1.30 (1.13–1.48)	<0.001
Overweight 25–30 kg/m²	1.11 (1.02–1.20)	0.011	1.02 (0.94–1.11)	0.64
Obesity >30 kg/m²	1.27 (1.15–1.41)	<0.001	1.16 (1.04–1.30)	0.001
Recipient clinical acuity
Diabetes at transplant	1.02 (0.93–1.12)	0.66	0.98 (0.89–1.08)	0.68
GFR
GFR <60	Reference (1)		Reference (1)
60–90	0.75 (0.66–0.85)		0.77 (0.68–0.88)	<0.001
>90	0.68 (0.60–0.77)		0.72 (0.64–0.82)	<0.001
Type of transplant
Unilateral	Reference		Reference (1)
Bilateral	0.80 (0.74–0.86)	<0.001	0.79 (0.72–0.86)	<0.001
Primary pulmonary diagnosis
Pulmonary fibrosis	Reference (1)		Reference (1)
COPD	0.90 (0.82–0.98)	0.02	1.09 (0.97–1.22)	0.16
Cystic fibrosis	0.80 (0.71–0.90)	<0.001	1.16 (0.96–1.40)	0.11
Pulmonary hypertension	1.13 (0.92–1.37)	0.24	1.40 (1.14–1.73)	0.002
Other	0.88 (0.80–0.97)	0.01	1.06 (0.95–1.18)	0.95
ABO mismatch	1.16 (1.03–1.30)		1.17 (1.03–1.32)	0.01
Mechanical ventilation	1.58 (1.38–1.82)	<0.001	1.08 (0.92–1.28)	0.34
ECMO support	2.06 (1.53–2.77)	<0.001	1.34 (0.98–1.84)	0.06
Nonhospitalization	Reference		Reference (1)
Non-ICU hospitalization	1.30 (1.15–1.47)	<0.001	1.36 (1.19–1.54)	<0.001
ICU hospitalization	1.97 (1.75–2.20)	<0.001	1.96 (1.69–2.27)	<0.001

Adjusted for graft ischemic time and waitlist duration in addition to variables in the table. LAS: lung allocation score, BMI: body mass index, COPD: chronic obstructive pulmonary disease, and ECMO: extracorporeal membrane oxygenation.