Donor cause of death and mid-term survival in lung transplantation
| Autor: | Chris A Rogers, J. Saravana Ganesh, R.S. Bonser, Nicholas R. Banner |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Time Factors Adolescent medicine.medical_treatment Renal function Gastroenterology Risk Factors Internal medicine Cause of Death Medicine Lung transplantation Humans Prospective Studies Prospective cohort study Survival analysis Cause of death Transplantation business.industry Proportional hazards model Middle Aged Survival Analysis Tissue Donors United Kingdom Surgery Blunt trauma Female Cardiology and Cardiovascular Medicine business Respiratory Insufficiency Lung Transplantation |
| Zdroj: | The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation. 24(10) |
| ISSN: | 1557-3117 |
| Popis: | The influence of donor cause of death (DCD) on survival after lung transplantation (LTx) is uncertain. This was investigated using data from a national prospective cohort study of adult single and bilateral LTx undertaken between July 1995 and June 2002.DCD was categorized a priori into vascular and tumor (V), traumatic (T), hypoxic brain damage (H) and infective (I) causes. All T donor deaths were the result of blunt trauma. Risk factors for early (30 days), late (30 days to 5 years) and overall (5 years) mortality were identified using Cox regression analysis.Of 580 eligible transplants, DCDs were classified as V (n = 372), T (n = 153), H (n = 38) and I (n = 17). V donors were older (median 42 years) than the others (medians27 years) (p0.001). T donors were more likely to be of male gender (p0.001). Two hundred fifty-nine patients died within 5 years of surgery. The median follow-up time of survivors was 37 months. Unadjusted 5-year Kaplan-Meier survival rates did not vary with DCD (p = 0.6). Cox analysis identified donor age group, recipient diagnosis, pre-operative recipient ventilation, donor-recipient size mismatch, donor-recipient blood group variance, cytomegalovirus (CMV) mismatch and recipient creatinine clearance as predictors of mortality. After adjustment for these risk factors, DCD was not identified as a predictor of early (p = 0.2), late (p = 0.5) or overall mortality (p = 0.4) in LTx recipients.We found that DCD did not affect mid-term survival after LTx. |
| Databáze: | OpenAIRE |
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