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Outcome of lung transplanted patients with primary graft dysfunction.
Eur J Cardiothorac Surg 2007; 31(1):75-82EJ

Abstract

OBJECTIVE

Primary graft dysfunction (PGD) causes significant mortality and morbidity after lung transplantation. The objectives of the study were to describe the clinical and histological sequelae of PGD.

METHODS

Histology of all patients receiving single-lung transplantation 1999-2004 (n=181) was reviewed. PGD was defined as diffuse radiological infiltration of the lung allograft occurring within the first 72h postoperatively.

RESULTS

One patient died intra-operatively. PGD was recorded in 63% (n=113) of 180 consecutive transplant recipients. Patients with PGD had a worse 90-day postoperative mortality (14% versus 3%, p=0.03) and 3-year survival (55% versus 77%, p=0.003). Freedom from bronchiolitis obliterans syndrome was similar in both groups. The maximal FEV(1) was significantly lower in patients with PGD, median 54% (quartiles 48-61%) predicted; compared to patients without PGD, median 59% (quartiles 54-69%) predicted (p=0.003). There was a significant linear trend in the decline of maximal FEV(1) with the presence and increasing severity of radiographic infiltrate (p=0.004). During follow-up, patients with PGD were more likely to demonstrate diffuse alveolar damage or bronchiolitis obliterans organizing pneumonia (p=0.009 and p=0.01, respectively). Histological findings of diffuse alveolar damage correlated closely with extent of radiological infiltration (p<0.0001).

CONCLUSIONS

Transplant recipient survival, lung function, and histological findings of diffuse alveolar damage appear to be closely correlated with the appearance and severity of PGD.

Authors+Show Affiliations

Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. cmburton@doctors.net.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17134909

Citation

Burton, Christopher M., et al. "Outcome of Lung Transplanted Patients With Primary Graft Dysfunction." European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, vol. 31, no. 1, 2007, pp. 75-82.
Burton CM, Iversen M, Milman N, et al. Outcome of lung transplanted patients with primary graft dysfunction. Eur J Cardiothorac Surg. 2007;31(1):75-82.
Burton, C. M., Iversen, M., Milman, N., Zemtsovski, M., Carlsen, J., Steinbrüchel, D., ... Andersen, C. B. (2007). Outcome of lung transplanted patients with primary graft dysfunction. European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, 31(1), pp. 75-82.
Burton CM, et al. Outcome of Lung Transplanted Patients With Primary Graft Dysfunction. Eur J Cardiothorac Surg. 2007;31(1):75-82. PubMed PMID: 17134909.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcome of lung transplanted patients with primary graft dysfunction. AU - Burton,Christopher M, AU - Iversen,Martin, AU - Milman,Nils, AU - Zemtsovski,Mikhail, AU - Carlsen,Jørn, AU - Steinbrüchel,Daniel, AU - Mortensen,Jann, AU - Andersen,Claus B, Y1 - 2006/11/28/ PY - 2006/08/15/received PY - 2006/10/18/revised PY - 2006/10/23/accepted PY - 2006/12/1/pubmed PY - 2007/3/31/medline PY - 2006/12/1/entrez SP - 75 EP - 82 JF - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JO - Eur J Cardiothorac Surg VL - 31 IS - 1 N2 - OBJECTIVE: Primary graft dysfunction (PGD) causes significant mortality and morbidity after lung transplantation. The objectives of the study were to describe the clinical and histological sequelae of PGD. METHODS: Histology of all patients receiving single-lung transplantation 1999-2004 (n=181) was reviewed. PGD was defined as diffuse radiological infiltration of the lung allograft occurring within the first 72h postoperatively. RESULTS: One patient died intra-operatively. PGD was recorded in 63% (n=113) of 180 consecutive transplant recipients. Patients with PGD had a worse 90-day postoperative mortality (14% versus 3%, p=0.03) and 3-year survival (55% versus 77%, p=0.003). Freedom from bronchiolitis obliterans syndrome was similar in both groups. The maximal FEV(1) was significantly lower in patients with PGD, median 54% (quartiles 48-61%) predicted; compared to patients without PGD, median 59% (quartiles 54-69%) predicted (p=0.003). There was a significant linear trend in the decline of maximal FEV(1) with the presence and increasing severity of radiographic infiltrate (p=0.004). During follow-up, patients with PGD were more likely to demonstrate diffuse alveolar damage or bronchiolitis obliterans organizing pneumonia (p=0.009 and p=0.01, respectively). Histological findings of diffuse alveolar damage correlated closely with extent of radiological infiltration (p<0.0001). CONCLUSIONS: Transplant recipient survival, lung function, and histological findings of diffuse alveolar damage appear to be closely correlated with the appearance and severity of PGD. SN - 1010-7940 UR - https://www.unboundmedicine.com/medline/citation/17134909/Outcome_of_lung_transplanted_patients_with_primary_graft_dysfunction_ L2 - https://academic.oup.com/ejcts/article-lookup/doi/10.1016/j.ejcts.2006.10.024 DB - PRIME DP - Unbound Medicine ER -