Subscribe to RSS
DOI: 10.1055/s-2001-18421
Prognostication in Chronic Obstructive Pulmonary Disease: Implications for Lung Transplantation
Publication History
Publication Date:
14 November 2001 (online)
![](https://www.thieme-connect.de/media/srccm/200105/lookinside/thumbnails/10.1055-s-2001-18421-1.jpg)
ABSTRACT
Chronic obstructive pulmonary disease (COPD) is the most common disease for which single lung transplantation (SLT) is performed and is a frequent reason for bilateral lung transplantation (BLT). Recent data suggest a favorable survival advantage for patients with COPD undergoing lung transplantation compared with other diagnoses. This has led some investigators to question whether transplantation leads to improved survival in COPD patients compared with alternative treatment and whether this surgical therapy is appropriate in these individuals. These viewpoints may reflect the difficulties inherent in accurately predicting short- and long-term survival in patients with advanced COPD. Our review of the available data suggests that clinical, physiological, and radiographic features allow the identification of COPD patients with increased mortality despite maximal medical therapy. In these high risk individuals transplantation remains a viable therapeutic option.
KEYWORD
COPD - survival - lung transplantation
REFERENCES
- 1 Hosenpud J D, Bennett L E, Keck B M, Boucek M M, Novick R J. The Registry of the International Society for Heart and Lung Transplantation: seventeenth official report-2000. J Heart Lung Transplant . 2000; 19 909-931
- 2 Trulock E P. Lung transplantation. Am J Respir Crit Care Med . 1997; 152 947-952
- 3 Schulman L L. Lung transplantation for chronic obstructive pulmonary disease. Clin Chest Med . 2000; 21 849-865
- 4 Edelman J D, Kotloff R M. Lung transplantation: a disease-specific approach. Clin Chest Med . 1997; 18 627-644
- 5 Pochettino A, Kotloff R M, Rosengard B R. Bilateral versus single lung transplantation for chronic obstructive pulmonary disease: intermediate-term results. Ann Thorac Surg . 2000; 70 1813-1819
- 6 Sundaresan R S, Shiraishi Y, Trulock E P. Single or bilateral lung transplantation for emphysema?. J Thoracic Cardiovas Surg . 1996; 112 1485-1495
- 7 D'Armini A M, Callegari G, Vitulo P. Risk factors for early death in patients awaiting heart-lung or lung transplantation. Transplantation . 1998; 66 123-127
- 8 DeMeester J, Smits J MA, Persijn G G. Lung transplant waiting list: differential outcome of type of end-stage lung disease, one year after registration. J Heart Lung Trans . 1999; 18 563-571
- 9 Hosenpud J D, Bennett L E, Keck B M. Effect of diagnosis on survival benefit of lung transplantation for end-stage lung disease. Lancet . 1998; 351 24-27
- 10 DeMeester J D, Smits J MA, Persijn G G. Listing for lung transplantation: life expectancy and transplant effect, stratified by type of end-stage lung disease, the Eurotransplant Experience. J Heart Lung Trans . 2001; 20 518-524
- 11 American Thoracic Society. International guidelines for the selection of lung transplant candidates. Am J Respir Crit Care Med . 1998; 158 335-339
- 12 Hodgkin J E. Prognosis in chronic obstructive pulmonary disease. Clin Chest Med . 1990; 11 555-569
- 13 Nishimura K, Tsukino M. Clinical course and prognosis of patients with chronic obstructive pulmonary disease. Curr Op Pulm Med . 2000; 6 127-132
- 14 Burrows B, Earle R H. Prediction of survival in patients with chronic airways obstruction. Am Rev Respir Dis . 1969; 99 865-871
- 15 Traver G A, Cline M G, Burrows B. Predictors of mortality in chronic obstructive pulmonary disease: a 15-year follow-up study. Am Rev Respir Dis . 1979; 119 895-902
- 16 Anthonisen N R, Wright E C, Hodgkin J E. Prognosis in chronic obstructive pulmonary disease. Am Rev Respir Dis . 1986; 133 14-20
- 17 Anthonisen N R. Prognosis in chronic obstructive pulmonary disease: results from multicenter clinical trials. Am Rev Respir Dis . 1989; 140(suppl) 95-99
- 18 Hansen E F, Pharaneth K, Laursen L C. Reversible and irreversible airflow obstruction as predictor of overall mortality in asthma and chronic obstructive pulmonary disease. Am J Respir Crit Care Med . 1999; 159 1267-1271
- 19 Piccioni P, Caria E, Bignamini E. Predictors of survival in a group of patients with chronic airflow obstruction. J Clin Epidemiol . 1998; 51 547-555
- 20 Cooper C B, Waterhouse J, Howard P. Twelve-year clinical study of patients with hypoxic cor pulmonale given long-term domiciliary oxygen therapy. Thorax . 1987; 42 105-110
- 21 Diener C F, Burrows B. Further observations on the course and prognosis of chronic obstructive lung disease. Am Rev Respir Dis . 1975; 111 719-724
- 22 Postma D S, Burema J, Gimeno F. Prognosis in severe chronic obstructive pulmonary disease. Am Rev Respir Dis . 1979; 119 357-367
- 23 Postma D S, DeVries K, Koeter G H. Independent influence of reversibility of air-flow obstruction and non-specific hyperreactivity on the long-term course of lung function in chronic air-flow obstruction. Am Rev Respir Dis . 1979; 134 276-280
- 24 Postma D S, Gimeno F, van der Weele T L. Assessment of ventilatory variables in survival prediction of patients with chronic airflow obstruction: the importance of reversibility. Eur J Respir Dis . 1985; 67 360-368
- 25 Bates D V, Knott J MS, Christie R V. Respiratory function in emphysema in relation to prognosis. Q J Med . 1956; 25 137-157
- 26 Boushy S F, Thompson Jr K H, North L B. Prognosis in chronic obstructive pulmonary disease. Am Rev Respir Dis . 1973; 108 1373-1383
- 27 Kanner R E, Renzetti Jr D A, Stanish W M. Predictors of survival in subjects with chronic airflow limitation. Am J Med . 1983; 74 249-255
- 28 Chailleux E, Fauroux B, Binet G. Predictors of survival in patients receiving domiciliary oxygen therapy or mechanical ventilatory: a 10-year analysis of ANTADIR observatory. Chest . 1996; 109 741-749
- 29 Medical Research Council Working Party. Long-term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema. Lancet . 1981; 1 681-686
- 30 Gorecka D, Gorzelak K, Sliwinski P. Effect of long-term oxygen therapy on survival in patients with chronic obstructive pulmonary disease with moderate hypoxemia. Thorax . 1997; 52 674-679
- 31 Veale D, Chailleux E, Taytard A. Characteristics and survival of patients prescribed long-term oxygen therapy outside of prescription guidelines. Eur Respir J . 1998; 12 780-784
- 32 Foucher P, Baudouin N, Merati M. Relative survival analysis of 252 patients with COPD receiving long-term oxygen therapy. Chest . 1998; 113 1580-1587
- 33 Aida A, Miyamoto K, Nishimura M. Prognostic value of hypercapnia in patients with chronic respiratory failure during long-term oxygen therapy. Am J Respir Crit Care Med . 1998; 158 188-193
- 34 Connors Jr F A, Dawson N V, Thomas C. Outcomes following acute exacerbation of severe chronic obstructive lung disease. Am J Respir Crit Care Med . 1996; 154 959-967
- 35 Costello R, Deegan P, Fitzpatrick M. Reversible hypercapnia in chronic obstructive pulmonary disease: a distinct pattern of respiratory failure with a favorable prognosis. Am J Med . 1997; 103 239-244
- 36 Saryal S, Celik G, Karabiyikoglu G. Distinctive features and long-term survival of reversible and chronic hypercapnic patients with COPD. Monaldi Arch Chest Dis . 1999; 54 212-216
- 37 Strom K. Oral corticosteroid treatment during long-term oxygen therapy in chronic obstructive pulmonary disease: a risk factor for hospitalization and mortality in women. Respir Med . 1998; 92 50-56
- 38 Petty T L, Bliss P L. Ambulatory oxygen therapy, exercise, and survival with advanced chronic obstructivce pulmonary disease (The Nocturnal Oxygen Therapy Trial revisited). Respir Care . 2000; 45 204-213
- 39 Gerardi D A, Lovett L, Benoit-Connors M L. Variables related to increased mortality following out-patient pulmonary rehabilitation. Eur Respir J . 1996; 9 431-435
- 40 Bowen J B, Votto J J, Thrall R S. Functional status and survival following pulmonary rehabilitation. Chest . 2000; 118 697-703
- 41 American Thoracic Society. Standards for the Diagnosis and Care of Patients with Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med . 1995; 152(suppl) 77-120
- 42 Flaherty K R, Kazerooni E A, Martinez F J. Differential diagnosis of chronic airflow obstruction. J Asthma . 2000; 37 201-223
- 43 Gelb A F, Zamel N, Hogg J C. Pseudophysiologic emphysema resulting from severe small-airways disease. Am J Respir Crit Care Med . 1998; 158 815-819
- 44 Burrows B, Bloom J W, Traver G A. The course and prognosis of different forms of chronic airways obstruction in a sample from the general population. N Engl J Med . 1987; 317 1309-1314
- 45 Kazerooni E A. Radiologic evaluation of emphysema for lung volume reduction surgery. Clin Chest Med . 1999; 20 845-861
- 46 Keistinen T, Tuuponen T, Kivela S L. Survival experience of the population needing hospital treatment for asthma or COPD at age 50-54. Respir Med . 1998; 92 568-572
- 47 Vestbo J, Prescott E, Lange P. Vital prognosis after hospitalization for COPD: a study of a random population sample. Respir Med . 1998; 92 772-776
- 48 Wu M, Eriksson S. Lung function, smoking and survival in severe alpha1-antitrypsin deficiency, PiZZ. J Clin Epidemiol . 1988; 41 1157-1165
- 49 Seersholm N, Dirksen A, Kok-Jensen A. Airways obstruction and two-year survival in patients with severe alpha1-antitrypsin deficiency. Eur Respir J . 1994; 7 1985-1987
- 50 Seersholm N, Kok-Jensen A. Survival in relation to lung function and smoking cessation in patients with severe hereditary alpha1-antitrypsin deficiency. Am J Respir Crit Care Med . 1995; 151 369-373
- 51 The Alpha-1 Antitrypsin Deficiency Registry Study Group. Survival and FEV1 decline in individuals with severe deficiency of α1-antitrypsin. Am J Respir Crit Care Med . 1998; 158 49-59
- 52 Miyamoto K, Aida A, Nishimura M. Gender effect on prognosis of patients receiving long-term home oxygen therapy. Am J Respir Crit Care Med . 1995; 152 972-976
- 53 Incalzi R A, Fuso L, DeRosa M. Co-morbidity contributes to predict mortality of patients with chronic obstructive pulmonary disease. Eur Respir J . 1997; 10 2794-2800
- 54 Leibowitz D W, Caputo A L, Shapiro G C. Coronary angiography in smokers undergoing evaluation for lung transplantation: is routine use justified?. J Heart Lung Trans . 1994; 33 701-703
- 55 Incalzi R A, Fuso L, De Rosa M. Electrocardiographic signs of chronic cor pulmonale: a negative prognostic finding in chronic obstructive pulmonary disease. Circulation . 1999; 99 1600-1605
- 56 Oswald-Mammosser M, Weitzenblum E, Quoix E. Prognostic factors in COPD patients receiving long-term oxygen therapy: importance of pulmonary artery pressure. Chest . 1995; 107 1193-1198
- 57 Skwarsky K, MacNee W, Wraith P K. Predictors of survival in patients with chronic obstructive pulmonary disease treated with long-term oxygen therapy. Chest . 1991; 100 1522-1527
- 58 Keller A, Ragaz A, Borer P. Predictors of early mortality in patients with long-term oxygen home therapy. Respiration . 1985; 48 216-221
- 59 Wurternberger G, Zielinski J, Sliwinksy P. Survival in chronic obstructive pulmonary disease after diagnosis of pulmonary hypertension related to long-term oxygen therapy. Lung . 1990; 168(suppl) 762-769
- 60 Gray-Donald K, Gibbons L, Shapiro S H. Nutritional status and mortality in chronic obstructive pulmonary disease. Am J Respir Crit Care Med . 1996; 153 961-966
- 61 Schols A W J M, Slangen J, Volovics L. Weight loss is a reversible factor in the prognosis of chronic obstructive pulmonary disease. Am J Respir Crit Care Med . 1998; 157 1791-1797
- 62 Landbo C, Prescott E, Lange P. Prognostic value of nutritional status in chronic obstructive pulmonary disease. Am J Respir Crit Care Med . 1999; 160 1856-1861
- 63 Madill J, Gutierrez C, Grossman J. Nutritional assessment of the lung transplant patient: body mass index as a predictor of 90-day mortality following transplantation. J Heart Lung Trans . 2001; 20 288-296
- 64 Nocturnal Oxygen Therapy Trial Group. Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive pulmonary disease: a clinical trial. Ann Intern Med . 1980; 93 391-398
- 65 Dubois P, Machiels J, Smeets F. CO transfer capacity as a determining factor of survival for severe hypoxaemic COPD patients under long-term oxygen therapy. Eur Respir J . 1990; 3 1042-1047
- 66 Clini E, Sturani C, Porta R. Outcome of COPD patients performing nocturnal non-invasive mechanical ventilation. Resp Med . 1998; 92 1215-1222
- 67 Chaouat A, Weitzenblum E, Kessler R. A randomized trial of nocturnal oxygen therapy in chronic obstructive pulmonary disease patients. Eur Respir J . 1999; 14 1002-1008
- 68 Hjalmarsen A, Melbye H, Wilsgaard T. Prognosis for chronic obstructive pulmonary disease patients who receive long-term oxygen therapy. Int J Tuberc Lung Dis . 1999; 3 1120-1126