Benefit of Lung Transplant for Cystic Fibrosis Affirmed

April 3, 2008

Article

Lung transplantation should continue to be offered as a treatment option for children with cystic fibrosis, the authors of an article published in the March issue of Pediatric Transplantation maintain, directly challenging another recent study that questions the benefit of lung transplantation in this population.

THURSDAY, April 3 (HealthDay News) -- Lung transplantation should continue to be offered as a treatment option for children with cystic fibrosis, the authors of an article published in the March issue of Pediatric Transplantation maintain, directly challenging another recent study that questions the benefit of lung transplantation in this population.

Stuart C. Sweet, M.D., Ph.D., of Washington University in St. Louis, and colleagues offer a critique of an article published Nov. 22, 2007 in the New England Journal of Medicine that questions the benefit of lung transplantation, claiming that the study by Liou et al. is based on flawed interpretation of data.

Sweet and colleagues argue that bias against transplantation was introduced into Liou's study because the covariates used to predict survival were obtained well before the time of transplant when patients were healthier, resulting in an overestimation of predicted survival. In addition, the calculated hazard ratios are based on non-current measurements, which may have changed between listing and transplant, and do not reflect the benefit of transplantation on an individual patient basis.

An associated editorial agrees that the results of Liou et al. are erroneous. Sweet's team concludes, "Until lung disease from cystic fibrosis is eradicated, it would be unconscionable to preclude lung transplant as a treatment option for children with advanced lung disease caused by cystic fibrosis."

Abstract - Sweet Full Text (subscription or payment may be required)Editorial Abstract - Liou