The Munich-LTX-Score: predictor for survival after lung transplantation

Clin Transplant. 2012 Jan-Feb;26(1):173-83. doi: 10.1111/j.1399-0012.2011.01573.x. Epub 2011 Dec 20.

Abstract

Background: The purpose of this study was to create a prognostic score calculated one yr after LTX based on post-transplant factors inclusive of donor and recipient characteristics that could be used to predict long-term survival in patients after lung transplantation (LTX).

Methods: Uni- and multivariate analysis in 206 consecutive LTX patients identified independent risk factors for post-transplant mortality and onset of bronchiolitis obliterans syndrome. Munich-LTX-Score is devised by summing up each identified risk factor.

Results: Multivariate analyses revealed acute rejection, lymphocytic bronchiolitis, donor age ≥ 55 yr, and HLA-A ≥ 2-/DR ≥ 2 mismatch and single LTX to be independent negative predictors for long-term survival (p < 0.05). Munich-LTX-Score identified three discrete groups: low-, moderate-, and high risk. The actuarial five-yr survival after score calculation one yr after LTX of the entire cohort was 58%, compared with 91% in low-, 54% in moderate-, and 0% in the high-risk group (p < 0.001).

Conclusion: Within our cohort of patients calculation of the Munich-LTX-Score, consisting of donor-, recipient-, and post-transplant characteristics, one yr after LTX allowed to predict long-term survival of lung transplant recipients. After prospective validation, this score could identify patients who may benefit from intensified surveillance after LTX.

MeSH terms

  • Adolescent
  • Adult
  • Bronchiolitis Obliterans / etiology*
  • Bronchiolitis Obliterans / mortality*
  • Child
  • Female
  • Follow-Up Studies
  • Graft Rejection / etiology*
  • Graft Rejection / mortality*
  • Humans
  • Lung Transplantation / adverse effects*
  • Lung Transplantation / mortality*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Risk Factors
  • Survival Rate
  • Young Adult