1. Characteristics and clinical implications of pleural effusions after lung transplantation: A retrospective analysis of 195 thoracocenteses in 113 patients
- Author
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Jens Gottlieb, Christina Valtin, Moritz Z. Kayser, Raphael Ewen, and Oana Joean
- Subjects
Male ,medicine.medical_specialty ,Thoracocenteses ,Pleural effusion ,Thoracentesis ,medicine.medical_treatment ,030230 surgery ,Gastroenterology ,Pulmonary function testing ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Retrospective analysis ,Humans ,Lung transplantation ,Cumulative incidence ,Lung ,Retrospective Studies ,Transplantation ,business.industry ,medicine.disease ,Pleural Effusion ,Etiology ,030211 gastroenterology & hepatology ,business ,Lung Transplantation - Abstract
Despite advances in lung transplantation (LTx), morbidity, and mortality are high. We hypothesized that pleural effusions requiring thoracocentesis lead to poor outcomes after LTx. We performed a single-center retrospective analysis of thoracocenteses after initial hospital discharge in LTx patients between March 2008 and September 2020 to identify risk factors, etiologies, and outcomes. Of the 1223 patients included, 113 patients (9.2%) required a total of 195 thoracocenteses. The cumulative incidence of thoracocentesis was 10.6% at 1 year and 14.2% at 5 years after transplantation. We observed a bimodal distribution of pleural effusion onset with a threshold at 6 months. Late-onset effusions were mostly of malignant or cardiac origin. We observed a high rate of nonspecific effusions (41.5%) irrespective of the timepoint post-transplantation. Patients with late-onset effusions had significantly lower survival compared to a matched controlled group (HR 2.43; 95% CI (1.27-4.62). All pulmonary function parameters were significantly decreased in patients requiring thoracocentesis compared to matched controls. Male sex and re-transplantation were risk factors for pleural effusions. In conclusion, pleural effusions requiring thoracocentesis occur frequently in LTx patients and lead to a reduced long-term allograft function. Late-onset effusions are associated with a lower survival.
- Published
- 2021