High-risk age window for mortality in children with cystic fibrosis after lung transplantation

Pediatr Transplant. 2015 Mar;19(2):206-10. doi: 10.1111/petr.12401. Epub 2014 Nov 28.

Abstract

LTx in children with CF remains controversial. The UNOS database was queried from 1987 to 2013 for CF patients <18 yr of age at time of transplant. PCHR model was used to quantify hazard of mortality. 489 recipients were included in the survival analysis. The hazard function of post-transplant mortality was plotted over attained age to identify age window of highest risk, which was 16-20 yr. Unadjusted PCHR model revealed ages immediately after the high-risk window were characterized by lower hazard of mortality (HR = 0.472; 95% CI = 0.302, 0.738; p = 0.001). After adjusting for potential confounders, the decline in mortality hazard immediately after the high-risk window remained statistically significant (HR = 0.394; 95% CI: 0.211, 0.737; p = 0.004). Hazard of mortality in children with CF after LTx was highest between 16 and 20 yr of attained age and declined thereafter.

Keywords: age; allograft failure; cystic fibrosis; lung transplantation; survival.

MeSH terms

  • Adolescent
  • Age Factors
  • Allografts
  • Body Mass Index
  • Child
  • Cystic Fibrosis / mortality*
  • Cystic Fibrosis / surgery*
  • Female
  • Graft Survival
  • Humans
  • Lung Transplantation*
  • Male
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Young Adult