São Paulo Lung Transplantation Waiting List: Patient Characteristics and Predictors of Death

IntroductionNowadays, lung transplantation (LTx) allocation in Brazil is based mainly on waiting time. There is a need to evaluate the equity of the current lung allocation system.ObjectivesWe sought to (1) determine the characteristics of registered patients on the waiting list and (2) identify predictors of death on the list.Materials and MethodsWe analyzed the medical records as well as clinical and laboratory data of 164 patients registered on the waiting list from 2001 to June 2008. Predictors of mortality were obtained using Cox proportional hazards analysis.ResultsPatients who were registered on the waiting list showed a mean age of 36.1 ± 15.0 vs. 42.2 ± 15.7 years, considering those who did versus did not, die on the list, respectively (P = .054). Emphysema was the most prevalent underlying disease among the patients who did not die on the list (28.8%); its prevalence was low among the patients who died on the list (6.5%; P = .009). The following variables correlated with the probability of death on the waiting list: emphysema or bronchiectasis diagnosis (hazard ratio [HR] = 0.15; P = .002); activated partial thromboplastin time > 30 seconds (HR = 3.28; P = .002); serum albumin > 3.5 g/dL (HR = 0.41; P = .033); and hemoglobin saturation > 85% (HR = 0.44; P = .031).ConclusionsSome variables seemed to predict death on the LTx waiting list; these characteristics should be used to improve the LTx allocation criteria in Brazil.