A cohort study was conducted of 1,437 U.S. adult lung transplant recipients with CF from May 1, 2005, through December 31, 2012. The cohort was divided into a high-risk group and a low-risk group based on LAS. Survival data were examined using Kaplan-Meier estimates and Cox proportional hazard models to compare survival. The primary outcome was adjusted survival at 1 year after lung transplantation.
The high-risk group of 318 patients with a median LAS of 69.6 (interquartile range 56.3–87.2) was compared with a low-risk group of 1,119 patients with a median LAS of 38.8 (interquartile range 36.3–42.3). Patients in the high-risk group had a 41% increased relative risk of cumulative mortality at 1 year after transplantation compared with the low-risk group (16.1% vs 12.0%). After adjustment for known predictors of mortality, the risk of death at 1 year after transplantation remained elevated (hazard ratio = 1.41; 95% confidence interval = 1.00–2.01). The high-risk group had worse survival at 90 days and 2 years after lung transplantation.
High LAS are associated with worse survival in lung transplant recipients with CF.