Abstract English: Background Chronic obstructive pulmonary disease (COPD) remains a significant global health burden. Due to limited donor organs, it is essential to implement rigorous selection criteria for lung transplantation candidates to maximise survival outcomes. Methods This study is a systematic review and meta-analysis of mortality-associated prognostic factors, survival rates (SR), lung function and complications among COPD patients who underwent lung transplantation. We follow preferred reporting items for systematic reviews and meta-analyses 2020 guidelines and register this review in PROSPERO (CRD42024617160). Eligibility criteria guided article selection through Medline, Scopus, ProQuest, Central and manual searches. Study quality was assessed using the Newcastle–Ottawa scale (NOS). Data were extracted and analysed, including performing meta-analysis for relevant outcomes. Results Our analysis identified prognostic factors associated with post-transplant mortality, including increased age per year (HR: 1.03, 95% CI: 1.02–1.03; I 2 = 0%), diabetes mellitus (HR: 1.38, 95% CI: 1.22–1.57; I 2 = 0%), ECMO support (HR: 3.58, 95% CI: 1.95–6.57; I 2 = 5%) and white donor race (HR: 0.81, 95% CI: 0.74–0.89; I 2 = 0%). Other significant factors included previous lung surgery, non-alpha-1 antitrypsin deficiency, induction agent type, continuous mechanical ventilation, 6-min walk distance and pulmonary hypertension. Lung transplantation significantly improves survival in COPD patients, with pooled SR of 79.8% (95% CI: 69.2%–87.4%) at 1 year and 55.3% (95% CI: 47.3%–63.1%) at 5 years. Lung function also showed marked improvement. Reported complications included infections, metabolic complications, rejection and bronchiolitis obliterans syndrome. Conclusions This systematic review identifies the key prognostic factors associated with mortality in post-transplant COPD patients, as well as post-transplant SR, lung function improvements and common complications.
Faisal et al. (Thu,) studied this question.