Lung transplantation and concomitant cardiac surgery: Is it justified?

Biniwale, Reshma; Ross, David J.; Iyengar, Amit; Kwon, Ohmyoung; Hunter, Christopher L.; Aboulhosn, Jamil; Gjertson, David W.; Ardehali, A.

doi:10.1016/j.jtcvs.2015.10.027

Cited by 16 publications

(19 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Relative contraindications for listing patients included body mass index less than 18 or greater than 30, presence of cerebrovascular disease, renal insufficiency, or severe debilitation. 8,12 F I G U R E 1 UCLA lung transplantation volume by diagnosis category over time The postoperative clinical management of our center's lung transplant recipients has been previously described.…”

Section: Recipient Selection and Clinical Managementmentioning

confidence: 99%

“…No significant changes in post-transplant management algorithms, including immunosuppressive medications or rejection screening, were instituted during this study period. 8,12 F I G U R E 1 UCLA lung transplantation volume by diagnosis category over time…”

Section: Recipient Selection and Clinical Managementmentioning

confidence: 99%

“…Outcomes of lung transplantation with the use of concomitant cardiac surgery at our center have been previously reported 8. Operative variables collected included donor age, transplant procedure (right, left, double), operative times, and concomitant cardiac procedure.…”

mentioning

confidence: 99%

“…Although institutional protocols for GERD management (including recommendation of fundoplication for clinically symptomatic lung transplant candidates) and screening for acute rejection remained similar throughout the study, more proactive follow-up and earlier diagnosis of postoperative rejection episodes was likely present, but difficult to quantify on retrospective review. Similarly, while no formal changes to immunosuppressive regimens (including preferred strategy and target levels) and post-transplant infection prophylaxis regimens took place, subtle variation and earlier infectionintervention may have been present 8,12. In addition, consistently low incidence of primary graft dysfunction post-transplant after the implementation of a modified reperfusion technique (previously described) 27,28 may further contribute to reduction of CLAD.…”

mentioning

confidence: 99%

“…Operative variables collected included donor age, transplant procedure (right, left, double), operative times, and concomitant cardiac procedure. Outcomes of lung transplantationwith the use of concomitant cardiac surgery at our center have been previously reported 8. For patients in the pre-LAS group, the LAS…”

mentioning

confidence: 99%

See 4 more Smart Citations

Lung transplantation in the Lung Allocation Score era: Medium‐term analysis from a single center

Iyengar

Kwon

Sanaiha

et al. 2018

Clinical Transplantation

Self Cite

View full text Add to dashboard Cite

In 2005, the Lung Allocation Score (LAS) was implemented as the allocation system for lungs in the US. We sought to compare 5-year lung transplant outcomes before and after the institution of the LAS. Between 2000 and 2011, 501 adult patients were identified, with 132 from January 2000 to April 2005 (Pre-LAS era) and 369 from May 2005 to December 2011 (Post-LAS era). Kruskal-Wallis or chi-squared test was used to determine significance between groups. Survival was censored at 5 years. Overall, the post-LAS era was associated with more restrictive lung disease, higher LAS scores, shorter wait-list times, more preoperative immunosuppression, and more single lung transplantation. In addition, post-LAS patients had higher O requirements with greater preoperative pulmonary impairment. Postoperatively, 30-day mortality improved in post-LAS era (1.6% vs 5.3%, P = .048). During the pre- and post-LAS eras, 5-year survival was 52.3% and 55.3%, respectively (P = .414). The adjusted risk of mortality was not different in the post-LAS era (P = .139). Freedom from chronic lung allograft dysfunction was significantly higher in the post-LAS era (P = .002). In this single-center report, implementation of the LAS score has led to allocation to sicker patients without decrement in short- or medium-term outcomes. Freedom from CLAD at 5 years is improving after LAS implementation.

show abstract

Section: Recipient Selection and Clinical Managementmentioning

confidence: 99%

Section: Recipient Selection and Clinical Managementmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations