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Impact of immediate primary lung allograft dysfunction on bronchiolitis obliterans syndrome.
Am J Respir Crit Care Med 2007; 175(5):507-13AJ

Abstract

RATIONALE

Primary graft dysfunction is a common complication after lung transplantation and a significant risk factor for short- and long-term mortality.

OBJECTIVE

We examined the impact of primary graft dysfunction on bronchiolitis obliterans syndrome.

METHODS

We performed a retrospective cohort study of 334 adult lung transplant recipients at our program and graded the severity of primary graft dysfunction according to the International Society for Heart and Lung Transplantation definition. We evaluated the impact of primary graft dysfunction on acute rejection, lymphocytic bronchitis, and bronchiolitis obliterans syndrome stage 1, using univariable and multivariable Cox proportional hazards models.

MAIN RESULTS

Among the 334 recipients, 65 did not have primary graft dysfunction (grade 0), 130 had grade 1, 69 had grade 2, and 70 had grade 3. In the univariable analysis, all grades of primary graft dysfunction were associated with a significantly increased risk of bronchiolitis obliterans syndrome stage 1 (grade 1: relative risk [RR] = 1.73; grade 2: RR = 2.13; and grade 3: RR = 2.53, compared with grade 0). The multivariable model demonstrated that the increased risk of bronchiolitis obliterans syndrome associated with primary graft dysfunction was independent of acute rejection, lymphocytic bronchitis, and community-acquired respiratory viral infections. However, there was no association between primary graft dysfunction and acute rejection or lymphocytic bronchitis.

CONCLUSIONS

Primary graft dysfunction is associated with an increased risk of bronchiolitis obliterans syndrome independent of acute rejection, lymphocytic bronchitis, and community-acquired respiratory viral infections, and this risk is directly related to the severity of primary graft dysfunction.

Authors+Show Affiliations

Division of Pulmonary and Critical Care, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8052, St. Louis, MO 63110, USA.No affiliation info availableNo 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

17158279

Citation

Daud, Shiraz A., et al. "Impact of Immediate Primary Lung Allograft Dysfunction On Bronchiolitis Obliterans Syndrome." American Journal of Respiratory and Critical Care Medicine, vol. 175, no. 5, 2007, pp. 507-13.
Daud SA, Yusen RD, Meyers BF, et al. Impact of immediate primary lung allograft dysfunction on bronchiolitis obliterans syndrome. Am J Respir Crit Care Med. 2007;175(5):507-13.
Daud, S. A., Yusen, R. D., Meyers, B. F., Chakinala, M. M., Walter, M. J., Aloush, A. A., ... Hachem, R. R. (2007). Impact of immediate primary lung allograft dysfunction on bronchiolitis obliterans syndrome. American Journal of Respiratory and Critical Care Medicine, 175(5), pp. 507-13.
Daud SA, et al. Impact of Immediate Primary Lung Allograft Dysfunction On Bronchiolitis Obliterans Syndrome. Am J Respir Crit Care Med. 2007 Mar 1;175(5):507-13. PubMed PMID: 17158279.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of immediate primary lung allograft dysfunction on bronchiolitis obliterans syndrome. AU - Daud,Shiraz A, AU - Yusen,Roger D, AU - Meyers,Bryan F, AU - Chakinala,Murali M, AU - Walter,Michael J, AU - Aloush,Aviva A, AU - Patterson,G Alexander, AU - Trulock,Elbert P, AU - Hachem,Ramsey R, Y1 - 2006/12/07/ PY - 2006/12/13/pubmed PY - 2007/4/4/medline PY - 2006/12/13/entrez SP - 507 EP - 13 JF - American journal of respiratory and critical care medicine JO - Am. J. Respir. Crit. Care Med. VL - 175 IS - 5 N2 - RATIONALE: Primary graft dysfunction is a common complication after lung transplantation and a significant risk factor for short- and long-term mortality. OBJECTIVE: We examined the impact of primary graft dysfunction on bronchiolitis obliterans syndrome. METHODS: We performed a retrospective cohort study of 334 adult lung transplant recipients at our program and graded the severity of primary graft dysfunction according to the International Society for Heart and Lung Transplantation definition. We evaluated the impact of primary graft dysfunction on acute rejection, lymphocytic bronchitis, and bronchiolitis obliterans syndrome stage 1, using univariable and multivariable Cox proportional hazards models. MAIN RESULTS: Among the 334 recipients, 65 did not have primary graft dysfunction (grade 0), 130 had grade 1, 69 had grade 2, and 70 had grade 3. In the univariable analysis, all grades of primary graft dysfunction were associated with a significantly increased risk of bronchiolitis obliterans syndrome stage 1 (grade 1: relative risk [RR] = 1.73; grade 2: RR = 2.13; and grade 3: RR = 2.53, compared with grade 0). The multivariable model demonstrated that the increased risk of bronchiolitis obliterans syndrome associated with primary graft dysfunction was independent of acute rejection, lymphocytic bronchitis, and community-acquired respiratory viral infections. However, there was no association between primary graft dysfunction and acute rejection or lymphocytic bronchitis. CONCLUSIONS: Primary graft dysfunction is associated with an increased risk of bronchiolitis obliterans syndrome independent of acute rejection, lymphocytic bronchitis, and community-acquired respiratory viral infections, and this risk is directly related to the severity of primary graft dysfunction. SN - 1073-449X UR - https://www.unboundmedicine.com/medline/citation/17158279/Impact_of_immediate_primary_lung_allograft_dysfunction_on_bronchiolitis_obliterans_syndrome_ L2 - http://www.atsjournals.org/doi/full/10.1164/rccm.200608-1079OC?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -