What predicts the success of functional recovery after lung transplantation – a retrospective cohort study

Abstract

ABSTRACT Background: Lung transplantation (LTx) is an intensive medical treatment with a high risk of complications, decreased physical functioning and mortality. Functional recovery in the early phase after LTx differs greatly between patients and can influence hospital length of stay and long term physical functioning. Aim: The aim of this study was to investigate if preoperative physical function parameters predict the functional recovery after LTx. Patients and Methods: Patients who underwent screening and LTx at the University Medical Centre of Utrecht between January 2001 and February 2020 were included. Preoperative physical function parameters and conventional risk factors were entered in a Cox Proportional Hazards model. The primary outcome was the time to walk in the hospital room for the first time after LTx. Results: A total of 225 patients were included for data analysis. Preoperative physical function parameters were not significant in multivariate analysis. A hazard ratio of 1.663 (p=0.024) and 0.983 (p=0.039) was found for bilateral LTx and age, respectively. Conclusion and key findings: We found preoperative physical function parameters not to be associated with functional recovery after LTx, measured as the time to walk in the hospital room for the first time after LTx. At this moment it is too early to change the physiotherapeutic screening of LTx candidates. Functional recovery needs to be reinvestigated and defined differently in further research, to determine the role of preoperative physical function parameters in screening LTx candidates.