Time to extubation for lung transplant recipients represents a pragmatic end-point to guide the development of prognostic tests.

Abstract

The field of transplantation would benefit from the integration of advanced precision medicine techniques. Although predictive tests for lung transplantation require a well-defined clinical end-point, there exists no consensus regarding which outcomes are optimal end-points for these purposes. While many possible candidate end-points exist, we propose that time-to-extubation is an optimal end-point for prognostic tests because of its: clinical relevance; objectiveness; stability over time; and association with healthcare expenditure. Herein, we describe the rationale for this selection and present the limitations of alternative outcomes for this purpose. Using a 72-hour cut-off, time to extubation correlated well with Primary Graft Dysfunction Grade 3, intensive care unit and hospital length of stay, and a greater than 2-fold increase in healthcare cost ratios. Given that time-to-extubation is an objective measure that is readily measured by all lung transplant centers, this metric represents a preferred primary end-point for prognostic tests developed for lung transplantation.

• Authors: Andrew T Sage, John Peel, Jerome Valero, Jonathan C Yeung, Mingyao Liu, Marcelo Cypel, Beate Sander, Shaf Keshavjee
• Journal: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation (J Heart Lung Transplant) Vol. 42 Issue 11 Pg. 1515-1517 (11 2023) ISSN: 1557-3117 [Electronic] United States
• PMID: 37406839 (Publication Type: Journal Article)
• Copyright: Copyright © 2023 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Topics

• Humans
• Prognosis
• Airway Extubation
• Transplant Recipients
• Lung
• Lung Transplantation (methods)
• Retrospective Studies
• Length of Stay