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Primary graft dysfunction and long-term pulmonary function after lung transplantation.
J Heart Lung Transplant 2007; 26(10):1004-11JH

Abstract

BACKGROUND

Severe primary graft dysfunction (PGD) is associated with poor early outcomes after lung transplantation (LTx). Less is known about lingering effects of severe PGD on pulmonary function. The study's aim was to determine whether development of severe primary graft dysfunction in the perioperative period was associated with reduced long term rates of survival or with diminished long term pulmonary function.

METHODS

A retrospective review was performed on LTx recipients who received their transplant during the period from 1992 through 2005. PGD severity over the first 48 hours post-transplant was graded using International Society for Heart Lung Transplantation criteria. Pulmonary function was evaluated yearly, and bronchiolitis obliterans syndrome (BOS) was determined from measurements of forced expiratory volume in 1 second (FEV(1)).

RESULTS

A total of 374 patients survived at least 90 days post-transplant. Overall survival rates were worse in patients with Grade 3 PGD: 51% at 5 years and 11% at 10 years for patients with Grade 3 PGD; 64% at 5 years and 35% at 10 years for those with Grade 2 PGD; and 66% at 5 years and 38% at 10 years for Grade 0 to 1 PGD (p = 0.001). BOS-free survival rate for patients with Grade 3 PGD was lower compared to those with Grade 0 to 2 for bilateral lung recipients, but not for single-lung recipients. Bilateral lung recipients who developed Grade 3 PGD had a significantly worse mean FEV(1) than those who did not. For single-lung recipients, PGD grade did not correlate with post-transplant pulmonary function.

CONCLUSIONS

Development of Grade 3 PGD in the early post-operative period negatively affects long-term survival, BOS-free survival and pulmonary function of bilateral lung transplant recipients who survive the peri-operative period.

Authors+Show Affiliations

Department of Surgery, Division of Cardiovascular and Thoracic Surgery, University of Minnesota, Minneapolis, Minnesota 55455, USA.No 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

17919620

Citation

Whitson, Bryan A., et al. "Primary Graft Dysfunction and Long-term Pulmonary Function After Lung Transplantation." The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, vol. 26, no. 10, 2007, pp. 1004-11.
Whitson BA, Prekker ME, Herrington CS, et al. Primary graft dysfunction and long-term pulmonary function after lung transplantation. J Heart Lung Transplant. 2007;26(10):1004-11.
Whitson, B. A., Prekker, M. E., Herrington, C. S., Whelan, T. P., Radosevich, D. M., Hertz, M. I., & Dahlberg, P. S. (2007). Primary graft dysfunction and long-term pulmonary function after lung transplantation. The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, 26(10), pp. 1004-11.
Whitson BA, et al. Primary Graft Dysfunction and Long-term Pulmonary Function After Lung Transplantation. J Heart Lung Transplant. 2007;26(10):1004-11. PubMed PMID: 17919620.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Primary graft dysfunction and long-term pulmonary function after lung transplantation. AU - Whitson,Bryan A, AU - Prekker,Matthew E, AU - Herrington,Cynthia S, AU - Whelan,Timothy P M, AU - Radosevich,David M, AU - Hertz,Marshall I, AU - Dahlberg,Peter S, PY - 2007/02/19/received PY - 2007/06/15/revised PY - 2007/07/11/accepted PY - 2007/10/9/pubmed PY - 2007/10/24/medline PY - 2007/10/9/entrez SP - 1004 EP - 11 JF - The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation JO - J. Heart Lung Transplant. VL - 26 IS - 10 N2 - BACKGROUND: Severe primary graft dysfunction (PGD) is associated with poor early outcomes after lung transplantation (LTx). Less is known about lingering effects of severe PGD on pulmonary function. The study's aim was to determine whether development of severe primary graft dysfunction in the perioperative period was associated with reduced long term rates of survival or with diminished long term pulmonary function. METHODS: A retrospective review was performed on LTx recipients who received their transplant during the period from 1992 through 2005. PGD severity over the first 48 hours post-transplant was graded using International Society for Heart Lung Transplantation criteria. Pulmonary function was evaluated yearly, and bronchiolitis obliterans syndrome (BOS) was determined from measurements of forced expiratory volume in 1 second (FEV(1)). RESULTS: A total of 374 patients survived at least 90 days post-transplant. Overall survival rates were worse in patients with Grade 3 PGD: 51% at 5 years and 11% at 10 years for patients with Grade 3 PGD; 64% at 5 years and 35% at 10 years for those with Grade 2 PGD; and 66% at 5 years and 38% at 10 years for Grade 0 to 1 PGD (p = 0.001). BOS-free survival rate for patients with Grade 3 PGD was lower compared to those with Grade 0 to 2 for bilateral lung recipients, but not for single-lung recipients. Bilateral lung recipients who developed Grade 3 PGD had a significantly worse mean FEV(1) than those who did not. For single-lung recipients, PGD grade did not correlate with post-transplant pulmonary function. CONCLUSIONS: Development of Grade 3 PGD in the early post-operative period negatively affects long-term survival, BOS-free survival and pulmonary function of bilateral lung transplant recipients who survive the peri-operative period. SN - 1557-3117 UR - https://www.unboundmedicine.com/medline/citation/17919620/Primary_graft_dysfunction_and_long_term_pulmonary_function_after_lung_transplantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1053-2498(07)00531-1 DB - PRIME DP - Unbound Medicine ER -