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FEV1 as a guide to lung transplant referral in young patients with cystic fibrosis

Forced expiratory volume in one second (FEV1) is widely used to guide referral of patients with cystic fibrosis (CF) for lung transplantation. We reasoned that the best FEV1 in a 6‐month period (bFEV1) would be a useful marker of the need for transplant referral. We examined both the rate of decline and different threshold values of bFEV1 as prognostic indicators in young CF patients. In a case‐control analysis, rates of decline in and threshold values of bFEV1 of 28 patients dying between ages 7–18 years from 1980–1997 were compared to those of 28 age‐ and gender‐matched controls. The threshold analysis of bFEV1 values was then applied to all patients under age 19 years followed in our clinic from 1993–1997.