Pulmonary hypertension is not a risk factor for grade 3 primary graft dysfunction after lung transplantation.

Autor: Cottini SR; Surgical Intensive Care Medicine, University Hospital Zurich, Zurich, Switzerland., Brandi G; Surgical Intensive Care Medicine, University Hospital Zurich, Zurich, Switzerland., Pagnamenta A; Department of Intensive Care Medicine of the Ente Ospedaliero Cantonale (EOC): Intensive Care Unit of Regional Hospital of Mendrisio, Mendrisio, Switzerland.; Unit of Clinical Epidemiology, Ente Ospedaliero Cantonale, Bellinzona, Switzerland., Weder W; Division of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland., Schuepbach RA; Surgical Intensive Care Medicine, University Hospital Zurich, Zurich, Switzerland., Béchir M; Surgical Intensive Care Medicine, University Hospital Zurich, Zurich, Switzerland.; Swiss Paraplegic Center, Nottwil, Switzerland., Huber LC; Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.; Clinic for Internal Medicine, City Hospital Triemli, Zurich, Switzerland., Benden C; Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
Jazyk: angličtina
Zdroj: Clinical transplantation [Clin Transplant] 2018 May; Vol. 32 (5), pp. e13251. Date of Electronic Publication: 2018 Apr 30.
DOI: 10.1111/ctr.13251
Abstrakt: Grade 3 primary graft dysfunction (PGD3) represents the most important risk factor for patient mortality during the first year after lung transplantation (LTX). We investigated whether pretransplant pulmonary hypertension (PH) is a risk factor for the development of PGD3. This retrospective, single-center cohort study included 96 candidates undergoing right heart catheterization (RHC) prior to being listed for LTX between March 2000 and October 2015. Based on their mean pulmonary artery pressure (mPAP) levels, the patients were classified into 3 groups: (1) <25 mm Hg, (2) 25-34 mm Hg and (3) ≥35 mm Hg. Forty-seven patients were classified in group 1, 31 in group 2, and 18 in group 3. Fifteen recipients (16%, 95%-CI 8-23) developed PGD3. In the univariate analysis, the diagnosis of interstitial lung disease (ILD) compared to COPD (OR: 7.06, P = .005), blood transfusion >1000 mL during surgery (OR: 5.25, P = .005), the need for intra-operative cardio-pulmonary bypass (CPB) or extra-corporeal membrane oxygenation (ECMO) (OR: 4, P = .027), mPAP (OR 1.06, P = .007) and serum high density lipoprotein-cholesterol (HDL-C) (OR 0.09, P = .005) were associated with PGD3. In the multivariable logistic regression analysis, only HDL-C (OR 0.10, P = .016) was associated with PGD3 based on our single-center cohort data analysis.
(© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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