Lung transplant candidates who are about 5'3" or shorter have longer waiting times than taller candidates and are more likely to die within a year while waiting for a lung transplant, according to a study presented at the 2015 American Thoracic Society International Conference.
Shorter adults are also more likely to be placed on mechanical ventilation while they wait for lung transplantation, said lead author Jessica Sell, MPH, of the Columbia University Medical Center in New York.
The researchers retrospectively reviewed information from 13,341 adults initially listed for lung transplantation in the U.S. from 2010 and 2011. The data were provided by the Organ Procurement and Transplant Network/United Network for Organ Sharing. Baseline characteristics and 1-year waiting list mortality and transplant rates by height quartile were analyzed. The study was designed to adjust for other variables that could affect the results, such as age, sex, race, diagnosis, and ventilation or extracorpeal membrane oxygenation at listing.
A height of less than 162 cm (about 5'3") was associated with a 60% relative increase in the 1-year mortality rate, a 34% relative decrease in the 1-year transplant rate, and a 39% relative increase in the 1-year respiratory failure rate compared with those of average height (170 to 176.5 cm), according to Sell and fellow researchers.
"Access to lung transplantation for shorter lung transplant candidates could be improved by reformulating the LAS [Lung Allocation Score] calculation to provide greater transplant priority for this disadvantaged group," Sell said.
Although there is anecdotal evidence that suggests shorter adults wait longer for lung transplantation, this is the first study to the researchers' knowledge of an analysis that focuses on the impact of short stature on waiting time and waiting list mortality.