Abstract
Background:
Lung transplantation (LT) has been demonstrated as the only effective therapy for patients with end-stage lung diseases. Increasing listed lung transplant candidates and expanding volumes of lung transplant centers across China require well-organized programs and registry data collection based on the large population. This study aimed to summarize and analyze the data of LT development in China.
Methods:We retrospectively collected and analyzed data from the China Lung Transplantation Registry (CLuTR). Key data were reported from the registry with transplant types, indications, donor and recipient characteristics, outcomes and survival. The survival <30 days, 1-year and 3-year survival rates were estimated with risk factors identified.
Results:CLuTR contained data from 1053 lung transplants performed through January 1st, 2015 to December 31st, 2018 reported by 18 registered transplant centers. The largest category of diagnosis before transplantation was idiopathic interstitial pneumonitis. The total <30 days, 1-year and 3-year survival rates in CLuTR were 81.45%, 70.11%, and 61.16% with discrepancy by indications. Large proportion of recipients who were more than 60 years old required higher standard of care. Infection-related complications resulted in more death events in the early post-surgery periods. New York Heart Association grading at listing, extra-corporeal membrane oxygenation usage peri-transplantation, allograft dysfunction (primary graft dysfunction >Grade 0), renal insufficiency (estimated glomerular filtration rate <60 mL·min–1·1.73 m–2), were independently associated with a higher risk for 3-year mortality in the entire cohort.
Conclusions:Facing more end-stage of lung diseases and comorbidities, this study analyzed the outcomes and survival of LT recipients in China. Further prospectively stratified analyses with longer follow-up will be needed.
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1 Wuxi Lung Transplant Center, Wuxi People's Hospital affiliated to Nanjing Medical University, Wuxi, Jiangsu 214043, China; Chinese Lung Transplantation Quality Management and Control Center, Wuxi, Jiangsu 214043, China; Chinese Lung Transplantation Registry and Data Management Center, Wuxi, Jiangsu 214043, China
2 Center for Lung Transplantation, China-Japan Friendship Hospital, Beijing 100029, China
3 Department of Thoracic Surgery/Oncology State Key Laboratory and National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, China
4 Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
5 Wuxi Lung Transplant Center, Wuxi People's Hospital affiliated to Nanjing Medical University, Wuxi, Jiangsu 214043, China
6 Wuxi Lung Transplant Center, Wuxi People's Hospital affiliated to Nanjing Medical University, Wuxi, Jiangsu 214043, China; Chinese Lung Transplantation Quality Management and Control Center, Wuxi, Jiangsu 214043, China; Chinese Lung Transplantation Registry and Data Management Center, Wuxi, Jiangsu 214043, China; Center for Lung Transplantation, China-Japan Friendship Hospital, Beijing 100029, China