1. Impact of Total Ischemic Time and Disease Severity Class on Graft Function after Bilateral Lung Transplantation
- Author
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Khalil Aburahma, Nunzio D de Manna, Dietmar Boethig, Maximilian Franz, Pavel Iablonskii, Emma L Heise, Dmitry Bobylev, Murat Avsar, Mark Greer, Nicolaus Schwerk, Wiebke Sommer, Tobias Welte, Axel Haverich, Gregor Warnecke, Christian Kuehn, Jawad Salman, and Fabio Ius
- Subjects
Pulmonary and Respiratory Medicine ,Surgery ,General Medicine ,Cardiology and Cardiovascular Medicine - Abstract
Objectives Total ischemic time is considered a limiting factor in lung transplantation. In this retrospective study we investigate effects of ischemic time and disease burden on outcomes after bilateral lung transplantation. Methods 1,298 patients undergoing bilateral lung transplantation between January 2010 and May 2022 (Follow-up 100%, median 54 months) were included. Pre-transplant diseases ‘severity (recipient body mass index, recipient age, previous lung transplantation, Tacrolimus immunosuppression, preoperative recipient extracorporeal membrane oxygenation support, lung volume reduction) for graft failure was individually calculated and- as ischemic time- categorised. Vice-versa adjusted Cox models were calculated. Considering competing risks, we assessed cumulative incidences of airway obstructive complications and chronic lung allograft dysfunction with death as competing risk factors for primary graft dysfunction were assessed by binary logistic regression. Results Higher disease burden significantly accelerated chronic lung allograft dysfunction and death occurrence (p Conclusion The eventual graft survival disadvantage that results from an ischemic time between 7 and at least 11 hours is negligible in contrast to frequent recipients’ disease-based risk levels.
- Published
- 2023