Waiting List Mortality and Potential Risk Factors in Lung Transplant Candidates: A Single- Center Data

Objective Lung transplantation (LTx) is a critical treatment for end-stage lung disease; however, the availability of donor lungs is limited. This study aimed to assess survival durations, mortality risk factors, and waiting list mortality in patients listed for transplantation at a single-center setting. Materials and Methods A retrospective study was conducted on patients listed for lung transplantation at Kartal Koşuyolu Specialized Training and Research Hospital between January 1, 2017, and May 1, 2023. The patients were categorized into five groups: Obstructive, Vascular, Suppurative, Major Idiopathic Interstitial Pneumonia (IIP), and others. Kaplan-Meier analysis, the log-rank test, and Cox regression analyses were employed to identify mortality risk factors. Results Of the 202 patients listed for transplantation, 66.8% (n = 135) were male, with a mean age of 42.9 ± 15.25 years. A total of 34.7% (n = 70) of the patients died while on the waiting list. The Major IIP group had the highest mortality rate (47.7%). Significant mortality risk factors included height, Major IIP and vascular group status, systolic pulmonary artery pressure (PAPs), ECHO TAPSE/PAPs ratio, and pulmonary vascular resistance (PVR). A PAPs value of 52 or higher significantly increased mortality risk by 3.992 times. The vascular group had the lowest survival time (15.61 ± 4.98 months). Conclusion Donor shortages extend the waiting time for lung transplantations. Identifying the factors that influence waiting list mortality and survival is crucial for optimizing clinical management. The high mortality rates of Major IIP and vascular diseases emphasize the need for careful listing timing and risk assessment.