ArticleThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation2021
Bridging the survival gap in cystic fibrosis: An investigation of lung transplant outcomes in Canada and the United States.
Article in The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- The Changing Transplant Landscape in the Era of Elexacaftor/Tezacaftor/Ivacaftor: A Word of Caution.Clinical transplantation · 2025Article
- Unmasking the true value of cystic fibrosis transmembrane conductance regulator modulators.ERJ open research · 2025Article
- Linkage of the CF Foundation Patient Registry with the Scientific Registry of Transplant Recipients database.Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society · 2025Article
- Lung Allocation Score Exceptions in Persons with Cystic Fibrosis Undergoing Lung Transplant.Annals of the American Thoracic Society · 2024Article
- Identifying inequities in lung transplantation: a call for strategies and future research.JHLT open · 2023Article
- Cystic fibrosis survival outcomes following second lung transplant: The north American experience.Clinical transplantation · 2023Article
- Article
- A Conceptual Model for Sources of Differential Selection in Lung Transplant Allocation.Annals of the American Thoracic Society · 2023Article
- Association of Oxygen Therapy with the Natural Disease Progression of Cystic Fibrosis: A Multi-State Model of the European Cystic Fibrosis Society Patient Registry.Therapeutics and clinical risk management · 2023Article
- Survival difference between high-risk and low-risk CFTR genotypes after lung transplant.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2022Article
- Article
- Low body mass index as a barrier to lung transplant in cystic fibrosis.Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society · 2022Article
- A Framework for Using Real-World Data and Health Outcomes Modeling to Evaluate Machine Learning-Based Risk Prediction Models.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2022Article
- Article
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Authors and funding
14 authors.
Funding
Abstract
backgroundPrevious literature in cystic fibrosis (CF) has shown a 10-year survival gap between Canada and the United States (US). We hypothesized that differential access to and survival after lung transplantation may contribute to the observed gap. The objectives of this study were to compare CF transplant outcomes between Canada and the US and estimate the potential contribution of transplantation to the survival gap.
methodsData from the Canadian CF Registry and the US Cystic Fibrosis Foundation Patient Registry supplemented with data from United Network for Organ Sharing were used. The probability of surviving after transplantation between 2005 and 2016 was calculated using the Kaplan‒Meier method. Survival by insurance status at the time of transplantation and transplant center volume in the US were compared with those in Canada using Cox proportional hazard models. Simulations were used to estimate the contribution of transplantation to the survival gap.
resultsBetween 2005 and 2016, there were 2,653 patients in the US and 470 in Canada who underwent lung transplantation for CF. The 1-, 3-, and 5-year survival rates were 88.3%, 71.8%, and 60.3%, respectively, in the US compared with 90.5%, 79.9%, and 69.7%, respectively, in Canada. Patients in the US were also more likely to die on the waitlist (p < 0.01) than patients in Canada. If the proportion of who underwent transplantation and post-transplant survival in the US were to increase to those observed in Canada, we estimate that the survival gap would decrease from 10.8 years to 7.5 years.
conclusionsDifferences in waitlist mortality and post-transplant survival can explain up to a third of the survival gap observed between the US and Canada.
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