Delayed Chest Closure for Oversized Lung Allograft in Lung Transplantation: a Retrospective Analysis from Turkey

Abstract

Introduction The aim of this study was to evaluate the delayed chest closure (DCC) results in patients who underwent lung transplantation. Methods Sixty patients were evaluated retrospectively. Only bilateral lung transplantations and DCC for oversized lung allograft (OLA) were included in the study. Six patients who underwent single lung transplantation, four patients who underwent lobar transplantation, two patients who underwent retransplantation, and four patients who underwent DCC due to bleeding risk were excluded from the study. Forty-four patients were divided into groups as primary chest closure (PCC) (n=28) and DCC (n=16). Demographics, donor characteristics, and operative features and outcomes of the patients were compared. Results The mean age was 44.5 years. There was no significant difference between the demographics of the groups ( P >0.05). The donor/recipient predicted total lung capacity ratio was significantly higher in the DCC group than in the PCC group (1.06 vs . 0.96, P =0.008). Extubation time (4.3 vs . 3.1 days, P =0.002) and intensive care unit length of stay (7.6 vs. 5.2 days, P =0.016) were significantly higher in the DCC group than in the PCC group. In the DCC group, postoperative wound infection was significantly higher than in the PCC group (18.6% vs. 0%, P =0.19). Median survival was 14 months in all patients and there was no significant difference in survival between the groups (16 vs. 13 months, P =0.300). Conclusion DCC is a safe and effective method for the management of OLA in lung transplantation.

Risk factors of wound infection after lung transplantation: a narrative review

“…From literature search, a total of 8 studies (11)(12)(13)(14)(15)(16)(17)(18) were collected into the narrative review, the specific information of the collected articles were shown in Table S2. Of which 4 articles (11,13,14,17) were grouped by the delayed chest closure (DCC) execution and the other 4 articles (12,15,16,18) were grouped by the SSI occurred.…”

“…From literature search, a total of 8 studies (11)(12)(13)(14)(15)(16)(17)(18) were collected into the narrative review, the specific information of the collected articles were shown in Table S2. Of which 4 articles (11,13,14,17) were grouped by the delayed chest closure (DCC) execution and the other 4 articles (12,15,16,18) were grouped by the SSI occurred. Two articles performed multivariate regression analysis (12,13) to determine the independent risk factors of SSI after lung transplantation and the other 6 articles compared the SSI rate in different patients population.…”