Exercise testing parameters associated with post lung transplant mortality

Abstract

Exercise performance during cardiopulmonary exercise testing (CPET) is a predictor of all-cause mortality in the general population and in patients with coronary heart disease. Mortality beyond one-year after lung transplantation (LTx) is due to multiple causes, is difficult to predict, and has not been fully evaluated in LTx recipients. We hypothesized that, similar to other populations, exercise performance after LTx may be associated with mortality. A retrospective review of all LTx recipients who underwent CPET between 2001 and 2009 was conducted. Chosen endpoint was re-transplantation or death. Survival analysis was performed using Cox proportional-hazard models in 183 patients. After adjusting for bronchiolitis obliterans syndrome (BOS) score, for every 10% increment in percent-predicted peak watts or percent-predicted peak oxygen uptake patients were approximately 23% less likely to experience an endpoint. We conclude that after adjusting for BOS score, lower exercise capacity one-year post LTx is independently associated with mortality. This may imply a protective role of exercise capacity in the LTx population.