Risk Factors Predictive of One-year Mortality After Lung Transplantation
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Objectives: Lung transplantation (LTx) is a life-saving therapy for patients with end-stage lung disease. However, there remains a significant postoperative complication rate and mortality in this extreme patient group. The aim of the present study was to identify donor, recipient and perioperative risk factors for one-year mortality after LTx.
Methods: A total of 252 LTxs were performed in our institution between 2007 and 2013. Donor and recipient demographics and clinical characteristics of 1-year survivors and non-survivors were collected and compared retrospectively. Multivariate logistic regression analysis was performed on univariate predictors for 1-year mortality with an entry criterion of P < 0.05.
Results: Multivariate analysis revealed female-to-male transplantation (95% CI: 0.088-0.767; P = 0.015), lower pO2/FiO2-ratio at 72 h postoperatively (95% CI: 0.988-0.999; P = 0.024), need for postoperative extracorporeal membrane oxygenation (ECMO) support (95% CI: 0.035-0.658; P = 0.012) and on-pump technique (95% CI: 0.007-0.944; P = 0.045) as the only independent predictors for 1-year mortality. Mainly unplanned intraoperative conversion to cardiopulmonary bypass contributed to poorer survival in patients who underwent LTx using cardiopulmonary bypass (P < 0.001).
Conclusions: Our results show that the unplanned use of CPB (conversion from off- to on-pump) might adversely affect outcome after LTx. Also, the negative impact of female-to-male transplantation should not be underestimated during recipient selection. Furthermore, poor early postoperative oxygenation, particularly with the need for extracorporeal oxygenation, might be a very strong negative prognostic factor after LTx.
Hoang T, Han L, Hirschi S, Degot T, Leroux J, Falcoz P Ann Transplant. 2024; 29:e944420.
PMID: 39161071 PMC: 11344474. DOI: 10.12659/AOT.944420.
Volatile organic compound profiling to explore primary graft dysfunction after lung transplantation.
Stefanuto P, Romano R, Rees C, Nasir M, Thakuria L, Simon A Sci Rep. 2022; 12(1):2053.
PMID: 35136125 PMC: 8827074. DOI: 10.1038/s41598-022-05994-2.
Intraoperative support during lung transplantation.
Reck Dos Santos P, DCunha J J Thorac Dis. 2022; 13(11):6576-6586.
PMID: 34992836 PMC: 8662508. DOI: 10.21037/jtd-21-1166.
Tang S, Huang W, Zhang K, Chen W, Xie T Pak J Med Sci. 2019; 35(4):1072-1075.
PMID: 31372145 PMC: 6659056. DOI: 10.12669/pjms.35.4.1279.
Sabashnikov A, Mohite P, Zeriouh M, Zych B, Garcia-Saez D, Maier J J Thorac Dis. 2019; 11(Suppl 6):S929-S937.
PMID: 31183172 PMC: 6535489. DOI: 10.21037/jtd.2019.04.58.