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- Title
The Impact of New Treatments on Short- and MID-Term Outcomes in Bilateral Lung Transplant: A Propensity Score Study.
- Authors
Boscolo, Annalisa; Dell'Amore, Andrea; Pettenuzzo, Tommaso; Sella, Nicolò; De Cassai, Alessandro; Pistollato, Elisa; Cacco, Nicola; Manzan, Andrea; De Carolis, Agnese; Geraldini, Federico; Lorenzoni, Giulia; Pezzuto, Federica; Zambello, Giovanni; Schiavon, Marco; Calabrese, Fiorella; Gregori, Dario; Cozzi, Emanuele; Rea, Federico; Navalesi, Paolo
- Abstract
Background: Despite many efforts to improve organ preservation and recipient survival, overall lung transplant (LT) mortality is still high. We aimed to investigate the impact of 'prophylactic' veno-arterial extracorporeal membrane oxygenation (VA ECMO) and tacrolimus on 72-h primary graft dysfunction (PGD) and 30-day acute cellular rejection, respectively. Methods: All consecutive LT patients admitted to the Intensive Care Unit of the Padua University Hospital (February, 2016–2022) were screened. Only adult patients undergoing first bilateral LT and not requiring cardio-pulmonary bypass, invasive mechanical ventilation, and/or ECMO before LT, were included. A propensity score weighting analysis was employed to account for the non-random allocation of the subjects to different treatments. Results: A total of 128 LT recipients were enrolled. Compared to the 'off-pump'-group (n.47, 37%), 'prophylactic' VA ECMO (n.51,40%) recorded similar 72-h PGD values, perioperative blood products and lower acute kidney dysfunction. Compared with cyclosporine (n.86, 67%), tacrolimus (n.42, 33%) recorded a lower risk of 30-day cellular rejection, kidney dysfunction, and bacteria isolation. Conclusions: 'Prophylactic' VA ECMO recorded 72-h PGD values comparable to the 'off-pump'-group; while tacrolimus showed a lower incidence of 30-day acute cellular rejection.
- Subjects
LUNG transplantation; GRAFT rejection; PRESERVATION of organs, tissues, etc.; BLOOD products; EXTRACORPOREAL membrane oxygenation
- Publication
Journal of Clinical Medicine, 2022, Vol 11, Issue 19, p5859
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm11195859