Poster 10. New ways of reporting on Dutch lung transplant waiting list and outcomes

Thursday 14 march 2019

12:57 - 13:00h

Categories: Klinisch, Postersessie

Parallel session: Postersessies 2 - Clinical

E.T.M. Schiks

Nederlandse Transplantatie Stichting, Leiden, Nederland.

Through standardized information the Dutch Transplant Foundation (NTS) and the national thoracic transplantation advisory committee (LOTTO) want to provide patients insight in factors that influence lung waiting list and transplant outcomes. The first issue of the yearly patient report includes the waiting list of 1/1/2018, overviews on lung waiting list dynamics, mortality and transplantation, and transplant outcome. The data are stratified for ranges of Lung Allocations Scores (LAS) and 5 groups of primary diagnoses for transplantation (obstructive lung disease, pulmonary vascular disease, cystic fibrosis or immunodeficiency, restrictive lung disease, and other lung diseases).

The report shows a stable waiting list with 181 and 182 patients on 1/1/2015 and 1/1/2018 respectively, with 2 or 3 patients on high or exceptional LAS. However, the proportion of patients with obstructive lung disease increased 15% while for cystic fibrosis it declined with 45%. Mean LAS scores were lowest for obstructive lung diseases on both times (32.6 and 32.1 respectively). The patients in this group therefore have the longest average transplant waiting time (1.9 year, versus 0.6-1.5 year in other groups). Patients with restrictive lung disease died more rapidly on the waiting list, 68% of the patients that died on the waiting list died within 6 months, versus less than 30% in the patients with obstructive lung disease, pulmonary vascular disease and cystic fibrosis. However, this group of patients has a relatively short waiting time for transplantation (0.8 year). In the restrictive lung disease group more patients (27%) received a single lung transplant (others range: 3-10%). Overall 5-year survival (in the 2009-2013 cohort) and 1-year survival (in the 2015-2017 cohort) were 69% and 83% respectively. 

The first annual lung transplant waiting list and outcome report provides insights in the current Dutch lung transplant waiting list and differences per patient group which can be useful for informing patients.