Effect of changes in postoperative spirometry on survival after lung transplantation David P. Mason, MD, Jeevanantham Rajeswaran, MSc, Liang Li, PhD,

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Effect of changes in postoperative spirometry on survival after lung transplantation David P. Mason, MD, Jeevanantham Rajeswaran, MSc, Liang Li, PhD, Sudish C. Murthy, MD, PhD, Jang W. Su, MD, Gösta B. Pettersson, MD, PhD, Eugene H. Blackstone, MD The Journal of Thoracic and Cardiovascular Surgery Volume 144, Issue 1, Pages 197-203.e2 (July 2012) DOI: 10.1016/j.jtcvs.2012.03.028 Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Forced 1-second expiratory volume (FEV1% of predicted) after lung transplantation for single (SLTx) versus double (DLTx) lung transplant. Solid lines represent nonparametric estimates of mean spirometry values across time. Symbols are actual grouped data, without regard to repeated measurements, used as a crude verification of model fit. The Journal of Thoracic and Cardiovascular Surgery 2012 144, 197-203.e2DOI: (10.1016/j.jtcvs.2012.03.028) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Survival after lung transplantation stratified by single (SLTx) and double (DLTx) lung transplant. Solid lines represent parametric estimates of survival enclosed within 68% confidence bands equivalent to ±1 standard error. Symbols represent each death positioned on a vertical axis using the Kaplan-Meier estimator. Vertical bars are 68% confidence limits equivalent to ±1 standard error, and numbers in parentheses represent patients remaining alive and traced. The Journal of Thoracic and Cardiovascular Surgery 2012 144, 197-203.e2DOI: (10.1016/j.jtcvs.2012.03.028) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Forced 1-second expiratory volume (FEV1% of predicted) after lung transplantation (dashed lines) and its influence on hazard of death (solid lines). A, Single lung transplant, (B) double lung transplant, and (C) single lung (black lines) and double lung (gray lines) transplant. Only point estimates depicted. The Journal of Thoracic and Cardiovascular Surgery 2012 144, 197-203.e2DOI: (10.1016/j.jtcvs.2012.03.028) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Nomogram of multivariable equation presented in Table 2 illustrating the relationship between forced 1-second expiratory volume (FEV1% of predicted) at 5 years and survival after single or double lung transplant (LTx). Values for other risk factors were set as follows: age, 49 years; no bronchiectasis or cystic fibrosis; donor creatinine, 0.9 mg/dL; pretransplant FEV1, 29% of predicted; propensity score, .5. The Journal of Thoracic and Cardiovascular Surgery 2012 144, 197-203.e2DOI: (10.1016/j.jtcvs.2012.03.028) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Number of patients with spirometry measurements (forced 1-second expiratory volume, percentage of predicted [FEV1%]) available at and beyond various time points and number of spirometry measurements available for analysis. The Journal of Thoracic and Cardiovascular Surgery 2012 144, 197-203.e2DOI: (10.1016/j.jtcvs.2012.03.028) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure E2 Mirrored histogram of distribution of propensity scores for single lung transplant (LTx) (bars above zero line) and double lung transplant (bars below zero line). Darkened area represents matched patient pairs, showing that they cover the complete spectrum of cases. The Journal of Thoracic and Cardiovascular Surgery 2012 144, 197-203.e2DOI: (10.1016/j.jtcvs.2012.03.028) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure E3 Covariable balance for some selected variables before and after matching. Values in x-axis represent percentage of standardized difference∗ between single lung and double lung transplant groups. BMI, Body mass index; COD, cause of death; COPD, chronic obstructive pulmonary disease; FEV1, forced 1-second expiratory volume; FVC, forced vital capacity; LTx, lung transplant; Preop, preoperative. ∗Austin PC, Mamdani MM. A comparison of propensity score methods: a case-study estimating the effectiveness of post-AMI statin use. Stat Med. 2006;25:2084–2106. The Journal of Thoracic and Cardiovascular Surgery 2012 144, 197-203.e2DOI: (10.1016/j.jtcvs.2012.03.028) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions