• Lianne G Singer, Noori A Chowdhury, Marie E Faughnan, John Granton, Shaf Keshavjee, Theodore K Marras, D Elizabeth Tullis, Thomas K Waddell, and George Tomlinson.
• 1 Department of Medicine and.
• Am. J. Respir. Crit. Care Med. 2015 Oct 15;192(8):965-73.

RationaleThe average age of lung transplant recipients is increasing, and the mix of recipient indications for transplantation is changing.ObjectivesTo determine whether the health-related quality-of-life (HRQL) benefit of lung transplantation differs by recipient age and diagnosis.MethodsIn this prospective cohort study, we obtained serial HRQL measurements in adults with advanced lung disease who subsequently underwent lung transplantation (2004-2012). HRQL assessments included the St. George's Respiratory Questionnaire, 36-Item Short-Form Health Survey (SF-36), EQ-5D, Standard Gamble, and Visual Analog Scale for current health. We used linear mixed effects models for associations between age or diagnosis and changes in HRQL with transplantation. To address potential survivorship bias, we fitted Markov models to the distribution of discrete post-transplant health states (HRQL better than pretransplant, not better, or dead) and estimated quality-adjusted life-years post-transplant.Measurements And Main ResultsA total of 430 subjects were listed, 387 were transplanted, and 326 provided both pretransplant and post-transplant data. Transplantation conferred large improvements in all HRQL measures: St. George's change of -47 units (95% confidence interval, -48 to -44), 36-Item Short-Form Health Survey physical component summary score of 17.7 (16.5-18.9), EQ-5D of 0.27 (0.24-0.30), Standard Gamble of 0.48 (0.44-0.51), and Visual Analog of 44 (42-47). Age was not associated with meaningful differences in the HRQL benefits of transplantation. There was less HRQL benefit in interstitial lung disease than in cystic fibrosis.ConclusionsLung transplantation confers large HRQL benefits, which vary by recipient diagnosis, but do not differ substantially in older recipients.

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