Journal article
Lung Size Mismatch and Survival After Single and Bilateral Lung Transplantation
The Annals of thoracic surgery, Vol.96(2), pp.457-463
08/2013
DOI: 10.1016/j.athoracsur.2013.04.064
PMID: 23809729
Abstract
A higher predicted total lung capacity (pTLC)-ratio (=pTLC donor/pTLC recipient), suggestive of oversized allografts, is associated with improved survival after lung transplantation. It is unknown whether the pTLC-ratio has a different association with survival in bilateral (BLT) versus single lung transplantation (SLT).
The pTLC-ratio was calculated for all adult patients in the United Network of Organ Sharing lung transplant (LTx) registry who underwent first-time LTx in the post lung allocation score era, between May 2005 and April 2010. The LTx recipients were stratified according to procedure (BLT vs SLT). Risk of death at 1 year after LTx was analyzed using Kaplan-Meier survival and Cox proportional hazards models.
In the 4,520 BLT patients, each 0.1 increase in pTLC-ratio conferred a 7% decrease in the hazard for death at 1 year (p < 0.001) in univariate analysis. This association remained significant after controlling for diagnosis, comorbidities, acuity, donor, and transplant factors (hazard ratio [HR] 0.93, 95% confidence interval [CI] 0.88 to 0.98, p = 0.01). Additional adjustment by a propensity score to account for biases to oversizing showed similar results (HR 0.94, 95% CI 0.90 to 0.99, p = 0.018). In the 2,477 SLT patients, each 0.1 increase in pTLC-ratio conveyed a 6% decrease in the hazard for death at 1 year (p = 0.002) in univariate analysis, which did not persist in the multivariate model (HR 1.00, p = 0.8).
A higher pTLC-ratio, suggestive of an oversized allograft, is associated with improved survival after lung transplantation. This association is primarily evident in BLT patients.
Details
- Title: Subtitle
- Lung Size Mismatch and Survival After Single and Bilateral Lung Transplantation
- Creators
- Michael Eberlein - Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Hospitals and Clinics, Iowa City, IowaRobert M Reed - Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MarylandServet Bolukbas - Department of Thoracic Surgery, Dr.-Horst-Schmidt-Klinik, Wiesbaden, GermanyKalpaj R Parekh - Department of Thoracic and Cardiovascular Surgery, University of Iowa Hospitals and Clinics, Iowa City, IowaGeorge J Arnaoutakis - Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MarylandJonathan B Orens - Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MarylandRoy G Brower - Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MarylandAshish S Shah - Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MarylandLawrence Hunsicker - Division of Nephrology, University of Iowa Hospitals and Clinics, Iowa City, IowaChristian A Merlo - Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Resource Type
- Journal article
- Publication Details
- The Annals of thoracic surgery, Vol.96(2), pp.457-463
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.athoracsur.2013.04.064
- PMID
- 23809729
- ISSN
- 0003-4975
- eISSN
- 1552-6259
- Language
- English
- Date published
- 08/2013
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Anatomy and Cell Biology; Surgery; Nephrology; Cardiothoracic Surgery; Internal Medicine
- Record Identifier
- 9984025314002771
Metrics
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