Demographic differences in complication and failure to rescue rates following lung transplantation

JHLT Open Pub Date : 2026-02-01 Epub Date: 2025-11-15 DOI:10.1016/j.jhlto.2025.100440

Boateng Kubi MD, MPH , Ruby Singh MD, MPH , Elsayed Elsafy BS , Orit Abrahim MD, MPH , Lucy Nam MD , Akash Premkumar MD , Stevens Bontemps BS , Dane C. Paneitz MD, MPH , Marlena Sabatino MD , Eriberto Michel MD , Asishana A. Osho MD, MPH

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Abstract

Background

We evaluated the association between race/ethnicity and failure to rescue (FTR) following lung transplantation.

Methods

We conducted a retrospective cohort study of 34,184 patients undergoing primary lung transplantation (2006–2024). Race/ethnicity was categorized as non-Hispanic White (81.3%), non-Hispanic Black (9.5%), and Hispanic (9.1%). The primary outcome was FTR. Logistic regression identified predictors of FTR, while Cox proportional hazards models assessed the association between race/ethnicity and outcomes.

Results

Black patients experienced the highest rates of postoperative complications (26.3%) compared to non-Hispanic White (17.9%) and Hispanic patients (19.6%) (p < 0.001). Mortality rate was also highest among Black patients (6.8%) compared to White (5.0%) and Hispanic patients (4.8%) (p <0.001). However, race/ethnicity was not independently associated with FTR. Risk factors for FTR included dialysis at transplant (OR 2.05, 95% CI: 1.28–3.29, p=0.003), double lung transplant (OR 1.30, 95% CI: 1.09–1.56, p=0.004), and prolonged ischemic time (OR 1.05, 95% CI: 1.02–1.08, p=0.001).

Conclusions

While Black patients experienced higher complication and mortality rates, race/ethnicity was not independently linked to FTR after lung transplantation.

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肺移植术后并发症和抢救失败率的人口统计学差异

背景：我们评估了种族/民族与肺移植术后抢救失败（FTR）之间的关系。方法对2006-2024年间34,184例原发性肺移植患者进行回顾性队列研究。种族/民族分为非西班牙裔白人（81.3%）、非西班牙裔黑人（9.5%）和西班牙裔（9.1%）。主要结果是FTR。逻辑回归确定了FTR的预测因素，而Cox比例风险模型评估了种族/民族与结果之间的关系。结果黑人患者术后并发症发生率最高（26.3%），而非西班牙裔白人患者（17.9%）和西班牙裔患者（19.6%）（p < 0.001）。黑人患者的死亡率（6.8%）也高于白人（5.0%）和西班牙裔患者（4.8%）（p <0.001）。然而，种族/民族与FTR并不是独立相关的。FTR的危险因素包括移植时透析（OR 2.05, 95% CI: 1.28-3.29, p=0.003）、双肺移植（OR 1.30, 95% CI: 1.09-1.56, p=0.004）和缺血时间延长（OR 1.05, 95% CI: 1.02-1.08, p=0.001）。结论：虽然黑人患者有较高的并发症和死亡率，但种族/民族与肺移植后FTR无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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JHLT Open

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