Postoperative surgical complications after lung transplantation

Torre, Mercedes de la; Fernández, Ricardo; Fieira, Eva; González, D.; Delgado, María Isabel; Méndez, Lucía; Borro, J.M.

doi:10.1016/j.rppnen.2014.09.007

Cited by 16 publications

(7 citation statements)

References 9 publications

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“…These improvements have decreased the main immediate complications of lung transplantation, especially extra-thoracic complications, of which gastrointestinal complications are of particular interest given their potential need for immediate surgical intervention [2].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have shown that gastrointestinal complications are frequent in patients who have undergone lung transplantation and are an important source of postoperative morbidity and mortality. There are also reports that these complications may have an independent impact on patient survival [2–7]. Among them, early-onset (< 30 days) and severe complications have been associated with high mortality rates after lung transplantation [8, 9].…”

Section: Introductionmentioning

confidence: 99%

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Morbidity and mortality of serious gastrointestinal complications after lung transplantation

Zevallos-Villegas

Alonso-Moralejo

Cambra

et al. 2019

J Cardiothorac Surg

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BackgroundGastrointestinal complications after lung transplatation are associated with an increased risk of morbidity and mortality. This study aims to describe severe gastrointestinal complications (SGC) after lung transplantation.MethodsWe performed a prospective, observational study that included 136 lung transplant patients during a seven year period in a tertiary care universitary hospital. SGC were defined as any diagnosis related to the gastrointestinal or biliary tract leading to lower survival rates or an invasive therapeutic procedure. Early and late complications were defined as those occurring < 30 days and ≥ 30 days post-transplant. The survival function was calculated through the Kaplan-Meier estimator. Variables were analyzed using univariate and multivariate analysis. Statistical significance was defined as p < 0.05.ResultsThere were 17 (12.5%) SGC in 17 patients. Five were defined as early. Twelve patients (70.6%) required surgical treatment. Mortality was 52.9% (n = 9). Patients with SGC had a lower overall survival rate compared to those who did not (14 vs 28 months, p = 0.0099). The development of arrhythmias in the first 48 h of transplantation was a risk factor for gastrointestinal complications (p = 0.0326).ConclusionsSGC are common after lung transplantation and are associated with a considerable increase in morbidity-mortality. Early recognition is necessary to avoid delays in treatment, since a clear predictor has not been found in order to forecast this relevant comorbidity.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Morbidity and mortality of serious gastrointestinal complications after lung transplantation

Zevallos-Villegas

Alonso-Moralejo

Cambra

et al. 2019

J Cardiothorac Surg

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“…This correlation with peristalsis might be related to the degree of vagal nerve manipulation during LT surgery. 43 - 46 As the vagal nerve controls primary and secondary esophageal peristalsis, reduced vagal tone affects esophageal contraction amplitude and prolongs bolus clearance. 6 , 47 , 48 On the other hand, using a parasympathomimetic agent, bethanechol was shown to empower vagal innervation and improve peristalsis and bolus transit time in patients with severe ineffective esophageal motility.…”

Section: Discussionmentioning

confidence: 99%

Esophageal Motility Abnormalities in Lung Transplant Recipients With Esophageal Acid Reflux Are Different From Matched Controls

Elsheikh,

Akanbi,

Selby

et al. 2023

J Neurogastroenterol Motil

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Background/Aims There is an increased incidence of gastroesophageal reflux disease (GERD) after lung transplantation (LT) that can be associated with graft dysfunction. It is unclear if the underlying esophageal motility changes in GERD are different following LT. This study aimed to use esophageal high-resolution manometry (HRM) to explore GERD mechanisms in LT recipients compared to matched controls. Methods This was a retrospective study including patients with pathologic acid reflux who underwent HRM and pH testing at our healthcare facility July 2012 to October 2019. The study included 12 LT recipients and 36 controls. Controls were matched in a 1:3 ratio for age, gender, and acid exposure time (AET). Results LT recipients had less hypotensive esophagogastric junction (EGJ) (mean EGJ-contractile integral 89.2 mmHg/cm in LT vs 33.9 mmHg/cm in controls, P < 0.001). AET correlated with distal contractile integral and total EGJ-contractile integral only in LT group ( r = –0.79, P = 0.002 and r = –0.57, P = 0.051, respectively). Conclusions Following LT, acid reflux is characterized by a less hypotensive EGJ compared to controls with similar AET. The strongest correlation with AET after LT was found to be esophageal peristaltic vigor. These results add to the understanding of reflux after LT and may help tailor an individualized treatment plan.

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“…Pleural space complications, including empyema, pleural effusion, pneumothorax, and chylothorax, require treatment in approximately 22% of cases [ 20 ]. Pneumothorax is a source of air leaks in the parenchyma of the lung except for bronchial anastomosis complications, and it can occur when the donor/recipient size mismatch is severe [ 21 ]. Most of these complications can be resolved by maintaining and managing the chest tube; however, bronchial complications must be distinguished.…”

Section: Pleural Space Complicationsmentioning

confidence: 99%

Surgical Complications Affecting the Early and Late Survival Rates after Lung Transplantation

Suh

2022

J Chest Surg

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Since the first lung transplantation in humans was performed in 1963, patient selection, standardized procurement, and surgical techniques have been developed and established for this procedure. However, despite these developments, surgical complications continue to be important factors influencing patient morbidity and mortality, and efforts should be made to decrease morbidity and improve survival rates by understanding, rapidly detecting, and appropriately treating surgical complications.

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Postoperative surgical complications after lung transplantation

Cited by 16 publications

References 9 publications

Morbidity and mortality of serious gastrointestinal complications after lung transplantation

Morbidity and mortality of serious gastrointestinal complications after lung transplantation

Esophageal Motility Abnormalities in Lung Transplant Recipients With Esophageal Acid Reflux Are Different From Matched Controls

Surgical Complications Affecting the Early and Late Survival Rates after Lung Transplantation

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