Browse ATS 2021 Abstracts

HomeProgram ▶ Browse ATS 2021 Abstracts

ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.

Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.

Search Tips:

  • Use the keyword search to search by keyword or author's name.
  • Filter your search results by selecting the checkboxes that apply.
  • Click on "Clear" to clear the form and start a new search. .

Search results will display below the form.

Disparities in Lung Transplantation Among Patients with Idiopathic Pulmonary Fibrosis: Data from the IPF-PRO Registry

Session Title
A1869 - Disparities in Lung Transplantation Among Patients with Idiopathic Pulmonary Fibrosis: Data from the IPF-PRO Registry
Author Block: A. Swaminathan1, A. S. Hellkamp1, M. L. Neely1, S. Bender2, P. Luca3, E. S. White2, S. M. Palmer1, T. P. M. Whelan3, D. F. Dilling4, on behalf of the IPF-PRO Registry investigators; 1Duke Clinical Research Institute, Durham, NC, United States, Duke University Medical Center, Durham, NC, United States, 2Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, United States, 3Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Medical University of South Carolina, Charleston, SC, United States, 4Division of Pulmonary and Critical Care, Loyola University Chicago Stritch School of Medicine, Maywood, IL, United States.
Rationale: Idiopathic pulmonary fibrosis (IPF) is one of the leading indications for lung transplantation, yet the availability of this treatment modality is limited to a small proportion of patients. The purpose of this analysis was to identify clinical and socioeconomic characteristics that differentially predicted lung transplant compared with death. Methods: We evaluated data from the IPF-PRO Registry, a multi-center US registry of patients with IPF that was diagnosed or confirmed at the enrolling center in the previous 6 months, who were enrolled between June 2014 and October 2018. Patients who were on a lung transplant waiting list were not enrolled, but patients could be listed for transplant after enrollment. We performed a time-to-event analysis incorporating competing risks methodology to examine differential associations between pre-specified covariates and the risk of lung transplant versus death. Covariates included lung transplant eligibility factors (age, body mass index, and smoking status), clinical factors (sex, time since imaging evidence of fibrosis, disease severity metrics, quality of life measures, comorbidity count, concomitant emphysema, respiratory hospitalization) and socioeconomic factors (distance to enrolling center, lung transplant volume at enrolling center, median household income based on zip code, health insurance type). Variables were modeled as time-independent or time-dependent covariates as appropriate. Results: Among 955 patients with IPF, event rates of lung transplant and death were 7.4% and 16.3%, respectively, at 2 years. Age over 70 and a higher number of comorbidities were associated with a significantly greater risk of death versus transplant, whereas higher median household income (based on zip code), enrollment at a center that conducted >30 transplants per year, and prior respiratory hospitalization were associated with a greater risk of lung transplant versus death (Figure). Oxygen use with activity at enrollment was associated with both lung transplant and death, but more strongly with lung transplant (Figure). Lower FVC (up to 80% predicted) and lower DLco (up to 50% predicted) were associated with both lung transplant and death. Conclusions: For patients with IPF in the IPF-PRO Registry, socioeconomic factors differentially impact the risk of lung transplantation compared with death, irrespective of disease severity measures or transplant eligibility factors. Additional interventions are needed to mitigate inequalities based on socioeconomic status.