Cystic fibrosis patients of low SES are less likely to be accepted for lung transplant

Adult cystic fibrosis (CF) patients of low socioeconomic status (SES) have a greater chance of not being accepted for lung transplant after undergoing initial evaluation, according to a new study.

"While earlier studies have indicated that SES does not affect access to care for cystic fibrosis, ours is the first study to examine the relationship between SES and access to lung transplantation in these patients," said lead author Bradley S. Quon, MD, MSc, MBA, of the University of Washington Medical Center in Seattle. "In our nationally representative sample of adult patients with CF, we found that multiple indicators of SES were associated with greater odds of not being accepted for transplant."

The findings were published online ahead of print publication in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

The study included 2,167 adult CF patients from the CF Foundation Patient registry, all of whom underwent their first lung transplant evaluation as an adult between January 1, 2001, and December 31, 2009. Receipt of Medicaid insurance was used as the primary indicator of SES status. The outcome of interest was acceptance onto the waiting list for lung transplant after initial evaluation. Patients who were either declined or deferred were classified as not accepted, and an additional sensitivity analysis was performed based on the final decision of whether a patient was accepted or declined at the end of the study period.

Of the 2,167 patients included in the study, 1009 (47%) received Medicaid. Compared to non-Medicaid patients, the odds of not being accepted for lung transplant was 1.56 fold higher among Medicaid recipients. This relationship was independent of differences in disease severity, demographic factors, contraindications to lung transplant, and use of the lung allocation score.

Other indicators of low SES, including residing in lower income zip codes and not graduating from high school, were also independently associated with not being accepted for lung transplant after undergoing initial evaluation.

What is Cystic Fibrosis?

- Cystic Fibrosis (CF) is one of the UK's most common life-threatening inherited diseases.

- It is caused by a faulty gene that controls the movement of salt and water in and out of the cells within the body.

- Cystic Fibrosis affects the internal organs, especially the lungs and digestive system, by clogging them with thick sticky mucus. This makes it hard to breathe and digest food.

- Over 9,000 people in the UK have Cystic Fibrosis.

- If two carriers have a child, the baby has a 1 in 4 chance of having Cystic Fibrosis.