| Autor: |
Emily Cerier, Adwaiy Manerikar, Viswajit Kandula, Takahide Toyoda, Benjamin Thomae, Yuriko Yagi, Diego Mauricio Avella Patino, Kalvin Lung, Rafael Garza-Castillon, Ankit Bharat, Chitaru Kurihara |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
The Annals of thoracic surgery. |
| ISSN: |
1552-6259 |
| Popis: |
Primary graft dysfunction is a risk factor of early mortality after lung transplant. Models identifying patients at high risk for primary graft dysfunction are limited. We hypothesize high post-reperfusion systolic pulmonary artery pressure is a clinical marker for primary graft dysfunction.This is a retrospective review of 158 consecutive lung transplants performed at a single academic center from January 2020 through July 2022. Only bilateral lung transplants were included and patients with pre-transplant extracorporeal life support were excluded.Primary graft dysfunction occurred in 42.3% (n = 30). Patients with primary graft dysfunction had higher post-reperfusion systolic pulmonary artery pressure (41 ± 9.1mmHg) than those without (31.5 ± 8.8mmHg) (p0.001). Logistic regression showed post-reperfusion systolic pulmonary artery pressure is a predictor for primary graft dysfunction (Odds Ratio 1.14, 95% Confidence Interval 1.06-1.24, p0.001). Post-reperfusion systolic pulmonary artery pressure of 37mmHg was optimal for predicting primary graft dysfunction by Youden's Index. The receiver operating characteristic curve of post-reperfusion systolic pulmonary artery pressure at 37mmHg (sensitivity 0.77, specificity 0.78, area under curve 0.81), was superior to the pre-reperfusion pressure curve at 36mmHg (sensitivity 0.77, specificity 0.39, area under the curve 0.57) (p0.01).Elevated post-reperfusion systolic pulmonary artery pressure following lung transplant is predictive of primary graft dysfunction. Post-reperfusion systolic pulmonary artery pressure is more indicative of primary graft dysfunction than pre-reperfusion systolic pulmonary artery pressure. Using post-reperfusion systolic pulmonary artery pressure as a positive signal of primary graft dysfunction allows earlier intervention which could improve outcomes. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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