RETURN TO WORK AFTER LUNG TRANSPLANTATION

The social rehabilitation of lung transplant recipients becomes increa singly important as the results of lung transplantation improve. Altho ugh return-to-work (RTW) rates have been published for recipients of o ther organ transplants, no such data are available after lung transpla ntation. The purpose of this study was to determine what factors influ ence RTW after lung transplantation. Of 99 lung transplant recipients (43 single, 56 bilateral) surveyed from Denver, Colorado, (n = 49) and Toronto, Ontario, Canada (n = 50), 22% (n = 22) were employed, 38% (n = 38) were unemployed but medically able to work, 29% (n = 29) were m edically disabled, and 10% (n = 10) had retired. The RTW rate for thos e medically able to work was 37% (22/60), and it was identical at each center (n = 11). Only Canadian lung transplant recipients (36%, 4/11) secured new jobs, whereas all Colorado lung transplant recipients ret urned to their previous employment (100%, 11/11). A stepwise discrimin ant analysis revealed that (1) pre transplantation employment, (2) a d iagnosis of emphysema, cystic fibrosis, or primary pulmonary hypertens ion, (3) a self-report of being physically able to work, (4) greater f unctional improvement as measured by post-lung transplantation percent predicted forced vital capacity, and (5) post-lung transplantation 6- minute walk > 550 m positively influenced RTW. This analysis accuratel y profiled 82% of the employed and 76% of the unemployed recipients fo r an overall effectiveness of 79%. The findings of this study are that (1) a 37% employment rate for those physically able was comparable to other types of organ transplant recipients, (2) employment was not de termined by the type of lung transplantation procedure (single or bila teral), and (3) social factors remain employment barriers for some rec ipients, but their absence did not guarantee a better employment rate.