Impact of Sex and Age at Lung Transplantation on Long-Term Survival of Patients with Cystic Fibrosis

This is the authors' abstract. We don't add key points for this paper.

Careful selection of lung transplant (LT) recipients with cystic fibrosis (CF) may improve outcomes; therefore, we studied the impact of sex and age at the time of LT on long-term survival of patients with CF. LT recipients with CF who received post-LT care at our center between July 1, 2007 and April 30, 2021 were included. The primary outcome was death or retransplantation. Cox proportional hazard analysis and the Kaplan-Meier method were used. Of 59 included LT recipients, the median age at first LT was 28 (22, 36) years, 36 (61%) patients were ≥25 years old, and 30 (51%) were male. At the end of the study, 21 (36%) had died and 17 (29%) had required retransplantation, with a median lung allograft survival of 33.4 (16.1, 66.4) months. The remaining 21 patients (36%) were alive at a median of 68 (28, 112) months after primary LT. The probability of survival of male patients trended higher than that of female patients (66.7% vs 44.8%, p = 0.069). Compared to age < 25 years at LT, age ≥ 25 years was associated with a significantly higher probability of survival (63.9% vs 43.5%, p = 0.047). LT recipients with CF aged ≥ 25 years at LT had significantly higher survival than younger patients, and survival trended higher for male recipients compared to female recipients. These results identify an at-risk population of LT recipients who may warrant closer attention after LT. Large multicenter trials with adequate power are needed.