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Purpose Lung transplant (LTx) candidates may have both high and low body-mass index (BMI). We investigated the effects of BMI in lung transplantation outcome and survival. Methods Patients from our center (Feb-2012 to Jul-2019) were divided into 5 BMI groups: Results Out of 609 LTx recipients, etiology was 63.1% IPF, 24.3% COPD, and 12.6% others. Furthermore, 28.2% of patients were either underweight or normal weight, 36.9% were overweight, and 34.7% were obese as measured by BMI. Demographically, the patient population was 66% male, mean age 64±9, race 78% white 15% black, and 7% others, median LOS (17 days) and mean LAS 49±19. Kaplan-Meier graph (figure 1) showed no significant differences in 1,3,5 year survival among all the BMI groups (p=0.57). There were also no significant differences among all the groups with regard to LOS (p=0.91) and LAS (p=0.42). Conclusion Despite larger numbers of overweight patients, there was no evidence of negative effect in survival outcome after LTx. Additionally, LOS and LAS did not have any effect in survival among five groups of BMI. This outcome suggests lung transplantation could be expanded to a wider variety of BMI patients.

Purpose We sought to compare survival outcomes of lung transplant (LTx) patients after receiving donor lungs with increased or standard risk for exposure to human immunodeficiency (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV). Methods A retrospective review of a single institution database identified patients who received lung transplant from increased risk donor (IRD) or standard risk donor (SRD). Risk category was determined using the Public Health Service (PHS) criteria. The data included 609 lung transplants performed between March 2012 and July 2019. Survival outcomes were compared using Kaplan-Meier curves and log-rank tests. A multivariate Cox proportional hazards model analyzed patient age, sex, BMI, diagnosis, and CPB or ECMO use during surgery. Results Of the 609 total transplants, 166 (27%) used IRD lungs, and 443 (73%) used SRD lungs. Demographically, the patient population was 66% male, 79% White, 14% Black, 5% Hispanic, and 2% Asian. Recipients' mean age was 64 ± 9.1 and, median BMI 27.6 ± 4.7 kg/m2. IPF was the most common diagnosis, representing 63% of patients, followed by COPD with 24% and sarcoidosis with 4%. Males were significantly more likely to receive an IRD lung (X2= 7.86, p=0.0051). Additionally, IRD donors were significantly younger than SRD donors (p Conclusion PHS IRD lungs are an underutilized resource despite showing no decline in survival. This study can improve patient education surrounding the risk of donor derived transmissible disease.

Purpose This study sought to compare survival outcomes of lung transplant (LTx) patients who received a lung from a donor after brain death (DBD) or donor after cardiac death (DCD) using institutional data. Methods A single center, retrospective review identified 609 lung transplants performed between March 2012 and July 2019. Because only 14/609 LTx were DCD, DCD recipients were propensity score matched with DBD recipients. Propensity scores (PS) were determined using patient age, sex, race, diagnosis, BMI, CPB or ECMO use during surgery, and donor age. The PS model was verified by comparing 1:1, 1:3, and 1:5 pooled groups, and performing t-tests or chi-square analyses before and after matching. Survival outcomes were determined using Kaplan-Meier curves and log-rank tests. Results In total, 609 lung transplants were performed at our institution. Of these, 14 received a DCD lung. The mean age of the DCD group was 64.2 (sd = 5.7), and mean BMI was 29.2 kg/m2 (sd = 4.15). Mean donor age for DCD lungs was 31.9 (sd = 14.0). The PS matched DBD group did not significantly differ from the DCD group by age (p = 0.520), sex (p = 0.617), diagnosis (p = 0.414), pump use (p = 0.827), BMI (p = 0.178), or donor age (p = 0.240). For DCD recipients, the 30 day, 90 day, and 1 year survival was 100%, 100%, and 91%, respectively. For DBD recipients, 30 day, 90 day, and 1 year 95.7%, 94.2%, and 83.7%, respectively. A log-rank test of the PS matched data showed no significant difference in survival between DCD and DBD lungs, p=0.372. This finding was consistent across the 1:1, 1:3, and 1:5 PS matched groups. Conclusion Our experience indicates that DCD and DBD donor lungs provide comparable short-term survival. This finding agrees with other recent results, suggesting DCD donor lungs are a viable alternative and their use can be expanded.