Journal article
Parameters of donor–recipient size mismatch and survival after bilateral lung transplantation
The Journal of heart and lung transplantation, Vol.31(11), pp.1207-1213.e7
11/2012
DOI: 10.1016/j.healun.2011.07.015
PMID: 22036314
Abstract
The purpose of this study was to investigate the relationship between donor–recipient height, gender and predicted estimates of total lung capacity (pTLC) mismatches and post-transplant survival.
The lung transplant databases at three programs were reviewed. The pTLC ratios (donor pTLC/recipient pTLC) and height ratios (donor height/recipient height) were calculated retrospectively. Patients were grouped according to pTLC ratio ≤1.0 or >1.0 and height ratio ≤1.0 or >1.0, and according to gender (mis-)matching. A time-to-event analysis was performed for risk of death after transplantation conditional on 30-day survival using Kaplan–Meier survival and Cox proportional hazard models.
There were 211 adult bilateral lung transplant recipients who qualified for the analysis. Mean follow-up was comparable for all cohorts (range 2.21 to 3.85 years). In the univariate Cox proportional hazard models, a pTLC ratio >1.0 (HR 0.43, p = 0.002) and a height ratio >1.0 (HR 0.61, p = 0.03) were associated with better survival, and a female-donor-to-male-recipient gender mismatch (F-to-M) was associated with worse survival (HR 2.35, p = 0.01). In the multivariate Cox proportional hazard model accounting for F-to-M gender mismatch and height ratio >1.0, a pTLC ratio >1.0 remained associated with survival (HR 0.38, p = 0.015). However, accounting for a pTLC ratio >1.0, a height ratio of >1.0 and F-to-M mismatch were not associated with survival.
A pTLC ratio >1.0 is associated with improved survival after bilateral lung transplantation. The pTLC ratio might better reflect allograft–thorax mismatch than the height ratio, as it also accounts for effects of gender on lung and thoracic volumes.
Details
- Title: Subtitle
- Parameters of donor–recipient size mismatch and survival after bilateral lung transplantation
- Creators
- Michael Eberlein - Division of Pulmonary and Critical Care Medicine, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MarylandRobert M Reed - Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MarylandSolbert Permutt - Division of Pulmonary and Critical Care Medicine, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MarylandMayy F Chahla - Division of Hospital Medicine, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MarylandServet Bolukbas - Department of Thoracic Surgery, Dr. Horst Schmidt Klinik, Wiesbaden, GermanySteven D Nathan - Advanced Lung Disease Program, Inova Fairfax Hospital, Falls Church, VirginiaAldo Iacono - Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MarylandDavid B Pearse - Division of Pulmonary and Critical Care Medicine, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MarylandHenry E Fessler - Division of Pulmonary and Critical Care Medicine, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MarylandAshish S Shah - Division of Cardiac Surgery, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MarylandJonathan B Orens - Division of Pulmonary and Critical Care Medicine, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MarylandRoy G Brower - Division of Pulmonary and Critical Care Medicine, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
- Resource Type
- Journal article
- Publication Details
- The Journal of heart and lung transplantation, Vol.31(11), pp.1207-1213.e7
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.healun.2011.07.015
- PMID
- 22036314
- ISSN
- 1053-2498
- eISSN
- 1557-3117
- Language
- English
- Date published
- 11/2012
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984094376902771
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