Lung transplantation long-term survival is worse in patients who have undergone previous cardiac surgery.

Autor:	Schumer EM; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MD, USA., Saddoughi SA; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MD, USA., Spencer PJ; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MD, USA., Pochettino A; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MD, USA., Daly RC; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MD, USA., Villavicencio MA; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MD, USA.
Jazyk:	angličtina
Zdroj:	European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 2022 Sep 02; Vol. 62 (4).
DOI:	10.1093/ejcts/ezac437
Abstrakt:	Objectives: Approximately 10% of lung transplant recipients have had previous cardiothoracic surgery. We sought to determine if previous surgery affects outcomes after lung transplant at a national level. Methods: The United Network for Organ Sharing database was analysed from 2005 to 2019 to include adult patients who underwent lung transplant who had previous cardiac surgery and previous thoracic surgery. T-test and chi-squared analysis were used to compare perioperative outcomes. Long-term survival comparison was performed using the Kaplan-Meier method in an unadjusted and propensity-matched analysis. Results: Out of 24 784 lung transplants, 691 (2.7%) had previous cardiac surgery and 1321 (6.5%) had previous thoracic surgery. Operative mortality was worse in previous cardiac surgery [42 (6.1%)] versus no previous cardiac surgery [740 (3.1%), P < 0.001] and in previous thoracic surgery [65 (4.9%)] versus no previous thoracic surgery [717 (3.1%), P < 0.001]. The previous thoracic surgery group had more primary graft failure and treated rejection during the first-year post-transplant. There was no difference in stroke, dialysis, intubation and extracorporeal membrane oxygenation at 72 h. Long-term survival was significantly worse for lung transplant patients who had undergone previous cardiac surgery (median 3.8 vs 6.3 years, P < 0.001) due to an increase in cardiovascular deaths (P = 0.008) and malignancy (P = 0.043). However, there was no difference in previous thoracic surgery (median 6.6 vs 6.1 years, P = 0.337). Conclusions: Previous cardiac surgery prior to lung transplant results in worse survival related to cardiovascular death and malignancies. Previous thoracic surgery worsens perioperative outcomes but does not affect long-term survival. (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
Databáze:	MEDLINE
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