For patients with advanced lung diseases, lung transplantation may represent the ultimate therapeutic option. Although support by palliative care is recommended for these highly vulnerable patients, it is rarely established in clinical practice. The present study aims to comprehensively describe the characteristics and health care of patients on the lung transplant waiting list, as well as to identify indicators for palliative care needs and risk factors for death during the waiting period.Retrospective cohort analysis of patients waiting for a lung transplantation of the LMU University Hospital Munich; evaluation of routinely collected health data between July 1st 2016 and June 30th 2018 using descriptive methods and logistic regression.Overall, 242 patients were included in this study, 119 of them were female (49%). Their average age was 51 years (SD=12.1) and they had an average lung allocation score of 37.7 (SD=10.9, n=241/242) at the time they entered the waiting list. The most common diagnoses were chronic obstructive pulmonary disease (n=91/242, 38%), fibrosing lung diseases (n=73/242, 30%) and cystic fibrosis (n=36/242, 15%). Additionally, the patients had on average four chronic secondary diseases (SD=2.5; n=242). During the observation period, 137/242 patients (57%) received a transplant and 24/242 (10%) died before receiving a lung transplantation. Of the 242 patients, 195 (81%) visited the LMU University Hospital a median of two times during the study period, 54 of these 195 patients (28%) required acute care. For symptom management, 119 of 195 patients (59%) received medication relevant to palliative care. Only 5 of 195 patients (3%) had contact to the palliative care team. The number of comorbidities (p=0.03; OR=1.26; KI=1.02-1.54) and the number of days spent in the LMU University Hospital per observed month (p=0.00; OR=1.318; KI=1.134-1.531) were associated with a higher likelihood of death during the lung transplantation waiting period.The findings indicate palliative care needs among lung transplant candidates of the LMU University Hospital, yet palliative care services were rarely utilized. Implementation of structured assessments for symptom burden and palliative care needs may facilitate appropriate integration of palliative care services into the care of these patients.
