de Miguel-Díez J, Jiménez-García R, Hernández-Barrera V, de Miguel-Yanes JM, Méndez-Bailón M, López-de-Andres A. National Trends In Kidney, Heart And Liver Transplants Among Patients With And Without Chronic Obstructive Pulmonary Disease In Spain (2001-2015).
Int J Chron Obstruct Pulmon Dis 2019;
14:2235-2243. [PMID:
31576119 PMCID:
PMC6769026 DOI:
10.2147/copd.s213257]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 08/09/2019] [Indexed: 01/23/2023] Open
Abstract
Background
To describe trends and outcomes during admission for solid organ transplants, excluding lungs, in people with or without COPD in Spain (2001–2015).
Methods
We used national hospital discharge data to select all hospital admissions for kidney, heart and liver transplants. We estimated admission rates stratified by COPD status. We analyzed the Charlson Comorbidity Index, therapeutic procedures and outcomes.
Results
We identified 52,020 admissions (33,293 for kidney transplant, 3,937 for heart transplant and 14,790 for liver transplant). Patients with COPD accounted for 2.5%, 4.2% and 3.5% of kidney, heart and liver transplant patients, respectively. The number of kidney and liver transplants increased among COPD patients over the study period, whereas the number of heart transplants remained stable. In all cases, COPD patients were significantly older and had more coexisting medical conditions than those without COPD. Among patients who underwent a kidney transplant, there were no significant differences in the clinical characteristics analyzed between the groups, but the overall in-hospital mortality (IHM) rate was significantly higher in COPD patients than in those without COPD (2.22% vs 0.58%, p=0.008). There were no differences for any of the study variables or for the IHM rate in patients who underwent a heart transplant (14.63% in both groups). Among patients who underwent a liver transplant, COPD patients had lower prevalences of infection and complications than those without COPD. The IHM rate was also significantly lower in COPD patients than in non-COPD controls who underwent a liver transplant (4.07% vs 8.91%, p=0.002).
Conclusion
COPD prevalence in patients undergoing renal, heart and liver transplants is lower than it has been described in the general population. However, we did not find differences in the clinical characteristics analyzed between COPD and non-COPD patients. Furthermore, the IHM rate was only higher in COPD patients who underwent a kidney transplant but not in those undergoing a heart or liver transplant.
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