Pretransplant six‐minute walk test predicts peri‐ and post‐operative outcomes after pediatric lung transplantation |
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Authors: | Dean Yimlamai Dawn A Freiberger Anne Gould Jing Zhou Debra Boyer |
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Institution: | 1. Division of Gastroenterology and Nutrition, Department of Medicine, Boston Children's Hospital, , Boston, MA, USA;2. Pediatric Transplant Center, Boston Children's Hospital, , Boston, MA, USA;3. Department of Physical and Occupational Therapy, Boston Children's Hospital, , Boston, MA, USA;4. Clinical Research Center, Boston Children's Hospital, , Boston, MA, USA;5. Division of Respiratory Diseases, Department of Medicine, Boston Children's Hospital, , Boston, MA, USA |
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Abstract: | The purpose of the pretransplant assessment in lung transplantation is to determine a patient's need for transplant as well as their potential survival post‐procedure. In 2005, the UNOS introduced the LAS, a calculation based on multiple physiologic measures to determine need and likelihood for survival. Measures include NYHA class and the 6‐MWT. Some adult studies indicate a positive correlation with 6‐MWT and waiting list survival. In pediatric/adolescent patients, there are minimal data regarding the predictive value of physiologic markers in either wait list survival or post‐transplant outcome. A retrospective cohort study of 60 consecutive lung transplantations from 1990 to 2008 was performed at a pediatric tertiary care facility. Functional pretransplant assessments were abstracted from the medical record and compared with outcomes after transplantation. Results: a 6‐MWT of >1000 ft (305 m) prior to transplantation correlated with a shorter ICU stay (7 vs. 11 days, p = 0.046) and fewer days of mechanical ventilation (2 vs. 4, p = 0.04). A pretransplant 6‐MWT greater than 750 ft (229 m) correlated with shorter overall hospitalization (37 vs. 20 days, p = 0.03). Measuring pretransplant 6‐MWT tests for pediatric patients is valuable in predicting peri‐operative outcomes after lung transplantation. |
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Keywords: | lung transplantation six‐minute walk test survival pediatrics |
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