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Assessing the benefit of accepting a single lung offer now compared with waiting for a subsequent double lung offer

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dc.contributor.author Wang, Q en
dc.contributor.author Rogers, CA en
dc.contributor.author Bonser, RS en
dc.contributor.author Banner, NR en
dc.contributor.author Demiris, N en
dc.contributor.author Sharples, LD en
dc.date.accessioned 2014-06-06T06:51:12Z
dc.date.available 2014-06-06T06:51:12Z
dc.date.issued 2011 en
dc.identifier.issn 00411337 en
dc.identifier.uri http://dx.doi.org/10.1097/TP.0b013e31821060b5 en
dc.identifier.uri http://62.217.125.90/xmlui/handle/123456789/5381
dc.subject Cohort study en
dc.subject Lung transplantation en
dc.subject Organ allocation en
dc.subject Survival analysis en
dc.subject.other adult en
dc.subject.other age en
dc.subject.other aged en
dc.subject.other article en
dc.subject.other body mass en
dc.subject.other chronic obstructive lung disease en
dc.subject.other cohort analysis en
dc.subject.other controlled study en
dc.subject.other disease severity en
dc.subject.other female en
dc.subject.other forced expiratory volume en
dc.subject.other hazard en
dc.subject.other human en
dc.subject.other lung fibrosis en
dc.subject.other lung function en
dc.subject.other lung transplantation en
dc.subject.other major clinical study en
dc.subject.other male en
dc.subject.other mortality en
dc.subject.other priority journal en
dc.subject.other United Kingdom en
dc.subject.other Adult en
dc.subject.other Female en
dc.subject.other Great Britain en
dc.subject.other Humans en
dc.subject.other Lung Transplantation en
dc.subject.other Male en
dc.subject.other Middle Aged en
dc.subject.other Patient Acceptance of Health Care en
dc.subject.other Proportional Hazards Models en
dc.subject.other Pulmonary Disease, Chronic Obstructive en
dc.subject.other Pulmonary Fibrosis en
dc.subject.other Regression Analysis en
dc.subject.other Retrospective Studies en
dc.subject.other Risk Assessment en
dc.subject.other Risk Factors en
dc.subject.other Survival Analysis en
dc.subject.other Survival Rate en
dc.subject.other Time Factors en
dc.subject.other Tissue Donors en
dc.subject.other Treatment Outcome en
dc.subject.other Waiting Lists en
dc.subject.other Young Adult en
dc.title Assessing the benefit of accepting a single lung offer now compared with waiting for a subsequent double lung offer en
heal.type journalArticle en
heal.identifier.primary 10.1097/TP.0b013e31821060b5 en
heal.publicationDate 2011 en
heal.abstract Background: Comparisons of survival after single lung transplant (SLT) and bilateral lung transplant (BLT) are useful in making policy decisions, but a more relevant comparison for an individual patient is between accepting a single lung when offered and remaining on the waiting list with the potential to subsequently receive a suitable pair of lungs. Methods: U.K. data from a cohort of 1211 adult, first lung transplant candidates diagnosed with pulmonary fibrosis (PF) or chronic obstructive pulmonary disease (COPD), listed July 1995 to July 2006 and followed up till December 2007, were analyzed. A sequentially stratified proportional hazards model was used to assess mortality after SLT relative to continued waiting for BLT. Results: For patients with PF, SLT was associated with a significant reduction in hazard relative to waiting for BLT (hazard ratio 0.81, 95% confidence interval 0.68-0.97, P=0.021), particularly for older patients with body mass index less than 20 and forced expired volume in 1 sec is less than 1 L. In contrast, our results gave no support for accepting SLT rather than waiting for BLT for patients with COPD (hazard ratio 1.08, 95% confidence interval 0.92-1.29, P=0.35). Conclusion: The high pretransplant risk of death for patients with PF, particularly older patients with low body mass index and poor lung function, suggests that they would benefit from taking an SLT if offered. However, there is no benefit of accepting SLT rather than waiting for BLT for patients with COPD; this reflects the low relative hazard in the absence of transplant for these patients. Copyright 2011 by Lippincott Williams & Wilkins. en
heal.journalName Transplantation en
dc.identifier.issue 8 en
dc.identifier.volume 91 en
dc.identifier.doi 10.1097/TP.0b013e31821060b5 en
dc.identifier.spage 921 en
dc.identifier.epage 926 en


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