Factors Related to Postoperative Mortality in Lung Transplantation for Emphysema

Ferrer, Jaume; Rodrı́guez, Esther; Román, Antonio; Bravo, Carlos; Roldán, Javier de Gracia; Hermosilla, Eduardo; Canela, Mercedes

doi:10.1016/j.transproceed.2007.09.006

Cited by 20 publications

(11 citation statements)

References 38 publications

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“…Fourteen patients died in the first month after surgery. Compared with survivors, those who died had ischemic times longer than 6 hours, a greater tendency to require cardiopulmonary bypass during transplantation, and a higher incidence of hemothorax (10).…”

Section: Discussionmentioning

confidence: 98%

Update in Transplantation 2007

Corris¹,

Christie²

2008

Am J Respir Crit Care Med

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Section: Discussionmentioning

confidence: 98%

Update in Transplantation 2007

Corris¹,

Christie²

2008

Am J Respir Crit Care Med

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“…In single-lung transplants, six months were required before a significant difference in FEV1 was observed. Ferrer et al7 reported that mean values for FVC and FEV1 were 41.8% and 21.1% of the predicted values in a sample of 65 patients with emphysema. One must consider, however, that patients who underwent single-lung transplant may have exhibited worse performance in the post-operative examinations due to persistence and progression of disease in the native lung .…”

Section: Discussionmentioning

confidence: 99%

Spirometric Assessment of Lung Transplant Patients: One Year Follow-Up

Pêgo-Fernandes

Abrão

Fernandes

et al. 2009

Clinics

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OBJECTIVE: The purpose of this study was to compare spirometry data between patients who underwent single-lung or double-lung transplantation the first year after transplantation. INTRODUCTION: Lung transplantation, which was initially described as an experimental method in 1963, has become a therapeutic option for patients with advanced pulmonary diseases due to improvements in organ conservation, surgical technique, immunosuppressive therapy and treatment of post-operative infections. METHODS: We retrospectively reviewed the records of the 39 patients who received lung transplantation in our institution between August 2003 and August 2006. Twenty-nine patients survived one year post-transplantation, and all of them were followed. RESULTS: The increase in lung function in the double-lung transplant group was more substantial than that of the single-lung transplant group, exhibiting a statistical difference from the 1st month in both the forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC) in comparison to the pre-transplant values (p <0.05). Comparison between double-lung transplant and single lung-transplant groups of emphysema patients demonstrated a significant difference in lung function beginning in the 3rd month after transplantation. DISCUSSION: The analyses of the whole group of transplant recipients and the sub-group of emphysema patients suggest the superiority of bilateral transplant over the unilateral alternative. Although the pre-transplant values of lung function were worse in the double-lung group, this difference was no longer significant in the subsequent months after surgery. CONCLUSION: Although both groups demonstrated functional improvement after transplantation, there was a clear tendency to greater improvement in FVC and FEV1 in the bilateral transplant group. Among our subjects, double-lung transplantation improved lung function

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“…The prior study did not perform a rigorous evaluation of the many variables that may be associated with development of hemothorax, which we attempted to do. Another study by Ferrer and colleagues focused specifically on causes of death within 30 days of transplant in patients with COPD [6]. This study found that 30 day mortality was higher in patients with post-operative hemothorax, but did not evaluate the longer-term impact of hemothorax on survival.…”

Section: Discussionmentioning

confidence: 99%

“…In a retrospective study of 100 patients, hemothorax was shown to occur in 15 % of patients after lung transplantation, with 46 % of patients requiring surgery for massive hemothorax and an associated 40 % in hospital mortality [5]. In another series, 1 month mortality after bilateral lung transplantation for emphysema was found to be higher in patients who developed a hemothorax [6]. These results suggest that hemothorax is a serious complication that affects patient outcomes and requires special clinical attention.…”

Section: Introductionmentioning

confidence: 97%

Hemothorax following lung transplantation: incidence, risk factors, and effect on morbidity and mortality

Hong

King

Brown

et al. 2016

Multidiscip Respir Med

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Background: Hemothorax after lung transplantation may result in increased post-operative morbidity and mortality. Risk factors for developing hemothorax and the outcomes of patients who develop hemothorax have not been well studied. Methods: A retrospective chart review was performed on all patients who underwent lung transplantation at a single center between March 2009 and July 2014. Comparison was made between patients with and without hemothorax post-transplant. Results: There were 132 lung transplantations performed during the study period. Hemothorax was a complication in 17 (12.9 %) patients, occurring an average of 9 days after transplant. No difference was found between the hemothorax and non-hemothorax groups with respect to age, preoperative anticoagulation, lung allocation score, prior thoracotomy, coagulation profile, use of cardiopulmonary bypass, ischemic time, or postoperative P/F ratio. There was a trend towards a higher incidence of hemothorax in patients with underlying sarcoidosis and re-transplantation (p = 0.13 and 0.17, respectively). Hemothorax developed early (<48 h post-operatively) in 5 patients and presented in a delayed manner (≥48 h post-operatively) in 12 patients. Delayed hemothorax occurred primarily in the setting of anticoagulation (10 out of 12 patients). The hemothorax group had decreased ventilator-free days (p = 0.006), increased ICU length of stay (p = 0.01) and increased hospital length of stay (p = 0.005). Hemothorax was also associated with reduced 90-day survival (p = 0.001), but similar 1, 3, and 5-year survival (p = 0.63, p = 0.30, and p = 0.25), respectively). Conclusion: The development of hemothorax is associated with increased morbidity and decreased short-term survival. Hemothorax may present either within the first 48 h after surgery or in a delayed fashion, most commonly in the setting of anticoagulation.

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Factors Related to Postoperative Mortality in Lung Transplantation for Emphysema

Cited by 20 publications

References 38 publications

Update in Transplantation 2007

Update in Transplantation 2007

Spirometric Assessment of Lung Transplant Patients: One Year Follow-Up

Hemothorax following lung transplantation: incidence, risk factors, and effect on morbidity and mortality

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