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Definitions of primary graft dysfunction after lung transplantation: differences between bilateral and single lung transplantation.
J Thorac Cardiovasc Surg 2006; 132(1):140-7JT

Abstract

OBJECTIVE

The primary graft dysfunction definition has been applied to both bilateral lung transplantation and single lung transplantation. However, the differences between bilateral and single lung transplantation in terms of primary graft dysfunction remain unknown. This study aims to investigate the features and utility of the new primary graft dysfunction grading system by comparing early outcomes from bilateral and single lung transplantation.

METHODS

The primary graft dysfunction grade of 228 consecutive lung transplants (149 bilateral and 79 single lung transplants) at multiple postoperative time points was analyzed. Subgroup analysis with chronic obstructive pulmonary disease was performed to further validate the difference between bilateral lung transplantation and single lung transplantation.

RESULTS

The percentage of grade 3 primary graft dysfunction in bilateral and single lung transplants was 32% and 37% at 0 hours (T0), 9% and 33% at 12 hours (T12), 7% and 26% at 24 hours (T24), and 9% and 18% at 72 hours (T72), respectively. The prevalence of the grade 3 primary graft dysfunction (T24) was significantly different between those undergoing bilateral lung transplantation and those undergoing single lung transplantation (P = .02). The primary graft dysfunction grade (T0) significantly correlated with the duration of intubation in both bilateral (r = 0.35, P < .0001) and single (r = 0.42, P = .001) lung transplantation and length of intensive care unit stay in both bilateral (r = 0.31, P = .0002) and single (r = 0.33, P = .006) lung transplantation. These differences were validated by the subgroup analysis.

CONCLUSIONS

The prevalence of primary graft dysfunction grade is different between bilateral and single lung transplantation and varies with time. Although the primary graft dysfunction grade correlated with the early posttransplantation outcomes, for the purposes of description and further studies, primary graft dysfunction in bilateral and single lung transplantation should be considered separately.

Authors+Show Affiliations

Department of Allergy, Immunology, and Respiratory Medicine, Heart and Lung Transplant Unit, The Alfred Hospital, Monash University, Melbourne, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16798314

Citation

Oto, Takahiro, et al. "Definitions of Primary Graft Dysfunction After Lung Transplantation: Differences Between Bilateral and Single Lung Transplantation." The Journal of Thoracic and Cardiovascular Surgery, vol. 132, no. 1, 2006, pp. 140-7.
Oto T, Griffiths AP, Levvey BJ, et al. Definitions of primary graft dysfunction after lung transplantation: differences between bilateral and single lung transplantation. J Thorac Cardiovasc Surg. 2006;132(1):140-7.
Oto, T., Griffiths, A. P., Levvey, B. J., Pilcher, D. V., Williams, T. J., & Snell, G. I. (2006). Definitions of primary graft dysfunction after lung transplantation: differences between bilateral and single lung transplantation. The Journal of Thoracic and Cardiovascular Surgery, 132(1), pp. 140-7.
Oto T, et al. Definitions of Primary Graft Dysfunction After Lung Transplantation: Differences Between Bilateral and Single Lung Transplantation. J Thorac Cardiovasc Surg. 2006;132(1):140-7. PubMed PMID: 16798314.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Definitions of primary graft dysfunction after lung transplantation: differences between bilateral and single lung transplantation. AU - Oto,Takahiro, AU - Griffiths,Anne P, AU - Levvey,Bronwyn J, AU - Pilcher,David V, AU - Williams,Trevor J, AU - Snell,Gregory I, PY - 2005/12/24/received PY - 2006/03/06/revised PY - 2006/03/21/accepted PY - 2006/6/27/pubmed PY - 2006/7/19/medline PY - 2006/6/27/entrez SP - 140 EP - 7 JF - The Journal of thoracic and cardiovascular surgery JO - J. Thorac. Cardiovasc. Surg. VL - 132 IS - 1 N2 - OBJECTIVE: The primary graft dysfunction definition has been applied to both bilateral lung transplantation and single lung transplantation. However, the differences between bilateral and single lung transplantation in terms of primary graft dysfunction remain unknown. This study aims to investigate the features and utility of the new primary graft dysfunction grading system by comparing early outcomes from bilateral and single lung transplantation. METHODS: The primary graft dysfunction grade of 228 consecutive lung transplants (149 bilateral and 79 single lung transplants) at multiple postoperative time points was analyzed. Subgroup analysis with chronic obstructive pulmonary disease was performed to further validate the difference between bilateral lung transplantation and single lung transplantation. RESULTS: The percentage of grade 3 primary graft dysfunction in bilateral and single lung transplants was 32% and 37% at 0 hours (T0), 9% and 33% at 12 hours (T12), 7% and 26% at 24 hours (T24), and 9% and 18% at 72 hours (T72), respectively. The prevalence of the grade 3 primary graft dysfunction (T24) was significantly different between those undergoing bilateral lung transplantation and those undergoing single lung transplantation (P = .02). The primary graft dysfunction grade (T0) significantly correlated with the duration of intubation in both bilateral (r = 0.35, P < .0001) and single (r = 0.42, P = .001) lung transplantation and length of intensive care unit stay in both bilateral (r = 0.31, P = .0002) and single (r = 0.33, P = .006) lung transplantation. These differences were validated by the subgroup analysis. CONCLUSIONS: The prevalence of primary graft dysfunction grade is different between bilateral and single lung transplantation and varies with time. Although the primary graft dysfunction grade correlated with the early posttransplantation outcomes, for the purposes of description and further studies, primary graft dysfunction in bilateral and single lung transplantation should be considered separately. SN - 1097-685X UR - https://www.unboundmedicine.com/medline/citation/16798314/Definitions_of_primary_graft_dysfunction_after_lung_transplantation:_differences_between_bilateral_and_single_lung_transplantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5223(06)00499-5 DB - PRIME DP - Unbound Medicine ER -