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- Title
Risk factors predictive of one-year mortality after lung transplantation.
- Authors
Sabashnikov, Anton; Weymann, Alexander; Mohite, Prashant N.; Zych, Bartlomiej; Patil, Nikhil P.; García Sáez, Diana; Popov, Aron-Frederik; Zeriouh, Mohamed; Wahlers, Thorsten; Wittwer, Thorsten; Wippermann, Jens; De Robertis, Fabio; Bahrami, Toufan; Amrani, Mohamed; Simon, André R.
- Abstract
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.
- Subjects
LUNG transplantation; LUNG diseases; ORGAN donors; EXTRACORPOREAL membrane oxygenation; LOGISTIC regression analysis
- Publication
European Journal of Cardio-Thoracic Surgery, 2014, Vol 46, Issue 6, pe82
- ISSN
1010-7940
- Publication type
Article
- DOI
10.1093/ejcts/ezu383