Adverse outcomes associated with pulmonary hypertension in chronic obstructive pulmonary disease after bilateral lung transplantation

被引:13
作者
Hayes, Don, Jr. [1 ,2 ,4 ]
Tumin, Dmitry [1 ,5 ]
Budev, Maria M. [6 ]
Tobias, Joseph D. [3 ,5 ]
St John, Roy C. [7 ]
Kukreja, Jasleen [8 ]
机构
[1] Ohio State Univ, Coll Med, Dept Pediat, Columbus, OH 43210 USA
[2] Ohio State Univ, Coll Med, Dept Internal Med, Columbus, OH 43210 USA
[3] Ohio State Univ, Coll Med, Dept Anesthesiol, Columbus, OH 43210 USA
[4] Nationwide Childrens Hosp, Sect Pulm Med, Columbus, OH USA
[5] Nationwide Childrens Hosp, Dept Anesthesiol & Pain Med, Columbus, OH USA
[6] Cleveland Clin Fdn, Dept Pulm Med, 9500 Euclid Ave, Cleveland, OH 44195 USA
[7] Mt Cannel Hlth, Columbus, OH USA
[8] Univ Calif San Francisco, Med Ctr, Dept Surg, San Francisco, CA USA
关键词
Bilateral; Chronic obstructive pulmonary disease; Lung transplantation; Pulmonary hypertension; Survival; SURVIVAL; COPD; FIBROSIS; REGISTRY;
D O I
10.1016/j.rmed.2017.04.010
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The impact of pulmonary hypertension (PH) in chronic obstructive pulmonary disease (COPD) on survival after lung transplantation (LTx) is not known. Material and methods: First-time adult LTx recipients with COPD transplanted between May 2005 and September 2013 were identified in the United Network for Organ Sharing Registry database, and tracked from transplant date until death or censoring. Right heart catheterization (RHC) measurements at time of wait listing were used to predict all-cause mortality after LTx, with multivariable analyses stratified by transplant type. Results: Of 3362 COPD LTx recipients, 3105 were included in the analytic sample, with multiple imputation used to complete missing data on covariates. Multivariable analysis found the hazard of death to increase with a 10 mmHg increase in mean pulmonary artery pressure (mPAP) among recipients of bilateral LTx (HR = 1.12; 95% CI = 1.01, 1.24; p = 0.032), but not among recipients of single LTx (HR = 0.92; 95% CI = 0.80, 1.06; p = 0.234). Conclusion: PH prior to bilateral LTx in patients with COPD is associated with higher mortality risk. (C) 2017 Elsevier Ltd. All rights reserved.
引用
收藏
页码:102 / 108
页数:7
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