Graft ischemic time and outcome of lung transplantation -: A multicenter analysis

被引:158
作者
Thabut, G
Mal, H
Cerrina, J
Dartevelle, P
Dromer, C
Velly, JF
Stern, M
Loirat, P
Lesèche, G
Bertocchi, M
Mornex, JF
Haloun, A
Despins, P
Pison, C
Blin, D
Reynaud-Gaubert, M
机构
[1] Hop Beaujon, Div Pulm Med & Thorac Surg, Serv Pneumol & Reanimat, F-92110 Clichy, France
[2] Hop Marie Lannelongue, Div Thorac Surg, F-92350 Le Plessis Robinson, France
[3] Haut Eveque Hosp, Div Thorac Surg, Bordeaux, France
[4] Foch Hosp, Div Pulm Med, Suresnes, France
[5] Foch Hosp, Intens Care Unit, Suresnes, France
[6] Louis Praddel Hosp, Div Pulm Med, Lyon, France
[7] Laenneck Hosp, Div Pulm Med & Thorac Surg, Nantes, France
[8] Albert Michalon Hosp, Div Pulm Med & Thorac Surg, Grenoble, France
[9] Ste Margueritw Hosp, Div Thorac Surg, Marseille, France
关键词
lung transplantation; prognosis; acute lung injury; reperfusion injury;
D O I
10.1164/rccm.200409-1248OC
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Rationale: The effect of graft ischernic time on early graft function and long-term survival of patients who underwent lung transplantation remains controversial. Consequently, graft ischernic time has not been incorporated in the decision-making process at the time of graft acceptance. Objectives: To investigate the relationship between graft ischernic time and (1) early graft function and (2) long-term survival after lung transplantation. Measurements and main results: The data from 752 patients who underwent single lung transplantation (n = 258), bilateral lung transplantation (n = 247), and heart-lung transplantation (n = 247) in seven French transplantation centers during a 12-year period were reviewed. Independent data quality control was done to ensure the quality of the collected variables. Mean graft ischemic time was 245.8 +/- 96.4 minutes (range 50-660). After adjustment on I I potential confounders, graft ischernic time was associated with the recipient Pa-O2/Fl(O2) ratio recorded within the first 6 hours and with long-term survival in patients undergoing single or double lung transplantation but not in patients undergoing heart-lung transplantation. The relationship between graft ischemic time and survival appears to be of cubic form with a cutoff value of 330 minutes. These results were unaffected by the preservation fluid employed. Conclusions: The results of this large cohort of patients suggest a close relationship between graft ischernic time and both early gas exchange and long-term survival after single and double lung transplantation. Such relationship was not found in patients undergoing heart-lung transplantation. The expected graft ischernic time should be incorporated in the decision-making process at the time of graft acceptance.
引用
收藏
页码:786 / 791
页数:6
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