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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Cyst+Fibros
2016 ; 15
(2
): 196-203
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Predictors of non-referral of patients with cystic fibrosis for lung transplant
evaluation in the United States
#MMPMID26704622
Ramos KJ
; Quon BS
; Psoter KJ
; Lease ED
; Mayer-Hamblett N
; Aitken ML
; Goss CH
J Cyst Fibros
2016[Mar]; 15
(2
): 196-203
PMID26704622
show ga
BACKGROUND: Lung transplantation is an intervention that improves survival for
adult patients with cystic fibrosis (CF). Some patients with CF are never
referred for lung transplant evaluation despite meeting physiologic criteria for
referral. METHODS: We performed a retrospective analysis of adult patients
(?18years of age) in the Cystic Fibrosis Foundation Patient Registry (CFFPR),
eligible for their first evaluation for lung transplantation during the years
2001-2008 based on FEV1<30% predicted in two consecutive years. RESULTS: Within
the CFFPR, 1240 patients met eligibility criteria. Eight hundred and nine (65.2%)
were referred for lung transplant evaluation, and 431 (34.8%) were not referred.
In a multivariable model, Medicaid insurance (OR 1.79, 95% CI 1.29-2.47), older
age (per 5year increase; OR 1.25, 95% CI 1.13-1.39), lack of high school graduate
education (OR 2.27, 95% CI 1.42-3.64), and Burkholderia cepacia complex sputum
culture positivity (OR 2.48, 95% CI 1.50-4.12) were associated with non-referral,
while number of pulmonary exacerbations (OR 0.93, 95% CI 0.87-0.99) and
supplemental oxygen use (OR 0.59, 95% CI 0.43-0.81) were associated with
increased referral. CONCLUSIONS: Despite meeting lung function criteria for lung
transplant evaluation, 35% of patients with CF had not yet been referred to a
lung transplant center. Predictors of non-referral included markers of low
socioeconomic status, older age and B. cepacia complex sputum culture. Further
work is needed to understand the outcomes for non-referred patients in order to
refine referral recommendations in this population.