BODE may overestimate transplant benefit in COPD patients

March 6, 2018, American College of Chest Physicians

COPD remains the leading indication for lung transplantation worldwide and accounts for one third of all lung transplants performed. In order to qualify for a lung transplant, patients receive an evaluation and undergo rigorous testing to identify and exclude those with an excessive burden of comorbid conditions. The body mass index, obstruction, dyspnea and exercise capacity (BODE) score is an evaluation used to inform prognostic considerations for potential lung transplantation patients. This scoring system is widely used but has yet to be validated in the context of lung transplant. In a new study published in the journal Chest, researchers aimed to determine if patients selected as transplant candidates have a better survival rate than the BODE score indicates.

Researchers performed a retrospective analysis of survival according to the BODE score for 4,000 COPD patients in the United Network Organ Sharing database of lung transplant candidates. They compared survival against that observed in the cohort of COPD patients in which the BODE score was originally validated.

They found that in models controlling for BODE score and incorporating as a competing end point, the risk of death was higher in the BODE validation cohort. This shows that patients selected as candidates for lung transplantation survive considerably longer than predicted by the commonly used prognostic estimates extrapolated from the BODE validation cohort. In addition, results indicated that nonrespiratory cause of death was higher in the nontransplant cohort, which supports the idea that comorbid illnesses that are screened out by the transplant selection process contribute a significant amount of morbidity.

"Survival of patients with COPD who are considered candidates for lung transplantation is significantly better than would be predicted by extrapolation of survival from the cohort in which the BODE score was validated," said Dr. Robert Reed, key researcher. "This is likely due to a lower prevalence of attributable to the lung transplant evaluation screening process."

Explore further: Process used to select lung transplant patients may need to be changed: study

Related Stories

Process used to select lung transplant patients may need to be changed: study

November 14, 2017
With a limited number of lungs available, deciding who gets a transplant can be a matter of life or death. New research from the University of Maryland School of Medicine (UMSOM) suggests that the system for choosing transplant ...

Outcomes of lung transplantations since implementation of need-based allocation system

March 3, 2015
Since implementation of a medical need-based allocation system of donor lungs in 2005, double-lung transplantation has been associated with better graft survival than single-lung transplantation in patients with idiopathic ...

Older donor lungs should be considered for transplantation

November 9, 2017
With a scarcity of lungs available for transplantation, the use of lungs from donors older than age 60 has been shown to achieve reasonable outcomes and should be considered as a viable option, according to research published ...

Shift in lung allocation score alters transplant survival

May 8, 2013
(HealthDay)—An acute increase in lung allocation score (LAS) before transplantation is associated with worse post-transplant survival, according to a study published in the May 7 issue of the Annals of Internal Medicine.

Shorter stature appears to lead to higher mortality rates, longer waiting times for lung transplant

May 17, 2015
Lung transplant candidates who are about 5'3" or shorter have longer waiting times than taller candidates and are more likely to die within a year while waiting for a lung transplant, according to a study presented at the ...

Recommended for you

Taking the virus out of a mosquito's bite

December 12, 2018
They approach with the telltale sign—a high-pitched whine. It's a warning that you are a mosquito's next meal. But that mosquito might carry a virus, and now the virus is in you. Now, with the help of state-of-the-art technology, ...

Study identifies a key cellular mechanism that triggers pneumonia in humans

December 11, 2018
The relationship between influenza and pneumonia has long been observed by health workers. Its genetic and cellular mechanisms have now been investigated in depth by scientists in a study involving volunteers and conducted ...

Human antibody discovery could save lives from fungal killer

December 11, 2018
A new way to diagnose, treat and protect against stealth fungal infections that claim more than 1.5 million lives per year worldwide has been moved a step closer, according to research published in Nature Communications.

Effect of oral alfacalcidol on clinical outcomes in patients without secondary hyperparathyroidism

December 11, 2018
Treatment with active vitamin D did not decrease cardiovascular events in kidney patients undergoing hemodialysis, according to a research group in Japan. They have reported their research results in the December 11 issue ...

Dialysis patients at risk of progressive brain injury

December 10, 2018
Kidney dialysis can cause short-term 'cerebral stunning' and may be associated with progressive brain injury in those who receive the treatment for many years. For many patients with kidney failure awaiting a kidney transplant ...

Silicosis is on the rise, but is there a therapeutic target?

December 6, 2018
Researchers from the CNRS, the University of Orléans, and the company Artimmune, in collaboration with Turkish clinicians from Atatürk University, have identified a key mechanism of lung inflammation induced by silica exposure, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.