The standardized mortality ratio of patients who have had a lung transplant is 5 times higher than patients who have not been hospitalized, according to a new study published in the Journal of Cardiac Surgery. However, long-term mortality rates have declined consistently over the years.

Lung transplant is the basic treatment for patients with end-stage respiratory failure, and even though the procedure has been used for close to 60 years there are still some questions that remain to be answered.

Here, a team of researchers led by Alejandro Suarez-Pierre, MD, from the Department of Surgery at the University of Colorado School of Medicine in Aurora conducted a population-based nested case-control study to evaluate survival among patients with lung transplants following their operations compared to the general population.

The researchers analyzed 74,885 US residents who were not hospitalized as well as 14,977 patients who received a lung transplant between 1990 and 2007 and compared their 10-year survival rates. The patients were divided into 4 groups based on their disease, which included obstructive lung disease, pulmonary vascular disease, immunodeficiency disorders including cystic fibrosis, and restrictive lung disease per standard convention.

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The results showed that the 10-year survival rate of patients who received a lung transplant was 28%. While the population expected mortality rate was 19 deaths per 100 person-years, the observed ratio was 104 deaths per 100 person-years, which corresponded to a standardized mortality ratio of 5.39.

The authors found the biggest difference between the expected mortality rates and the observed rates in women, Hispanics, and those who received a single lung. The standardized mortality ratio of patients with cystic fibrosis and immunodeficiency disorders who received a lung transplant was the lowest at 4.57.

Standardized mortality ratios declined over time and went from 5.79 between 1990 and 1995 to 5.64 between 1996 and 2000, and 5.1 between 2001 and 2007. The researchers also found that standardized mortality ratios were at their highest in the first year following the transplant and then declined with time.


Iguidbashian J, Cotton J, King RW, et al. Survival following lung transplantation: a population-based nested case-control study. J Card Surg. Published online February 27, 2022. doi:10.1111/jocs.16365