Soresi, Simona, Zeriouh, Mohamed, Sabashnikov, Anton ORCID: 0000-0002-6289-1035, Sarang, Zubair, Mohite, Prashant N., Patil, Nikhil P., Mansur, Ashham ORCID: 0000-0002-0322-2480, Weymann, Alexander, Wippermann, Jens, Wahlers, Thorsten, Reed, Anna, Carby, Martin, Simon, Andre R. and Popov, Aron-Frederik ORCID: 0000-0003-4226-3004 (2016). Extended Recipient Criteria in Lung Transplantation: Impact of Pleural Abnormalities on Primary Graft Dysfunction. Ann. Thorac. Surg., 101 (6). S. 2112 - 2120. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1552-6259

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Abstract

Background. Because of improved surgical expertise and intraoperative management, pleural disease (PD+) represents a relatively minor contraindication to lung transplantation (LTx). The presence of pleural abnormalities from previous procedures or pleural involvement from fungal or bacterial disease is not considered a limiting factor for LTx. However there are no studies available to assess the impact of pleural diseases on short-and midterm outcomes after LTx. Methods. We retrospectively reviewed 163 consecutive patients who underwent LTx between 2010 and 2013. Patients were divided according to the presence of pleural abnormalities before the operation (PD+ versus PD-). The primary end point of the study was primary graft dysfunction (PGD; grade 3) and overall survival. To avoid possible selection bias and to heck the robustness of the results, a propensity score-matching analysis (1:3) was performed. Results. A total of 26 patients (16%) had pleural abnormalities before transplantation. Intra-and postoperative variables were comparable. PD+ was associated with a significantly higher incidence of PGD at 0 and 48 hours postoperatively (p = 0.037 and p = 0.032, respectively). Moreover, PD+ was associated with significantly worse survival at 3 months (p = 0.021). Although there was a trend toward worse early overall survival in the Kaplan-Meier estimate (Breslow p = 0.050), midterm survival was comparable (log-rank p = 0.240). Conclusions. LTx in patients with preoperative pleural abnormalities is feasible. Identifying higher-risk recipients with pleural abnormalities might have important clinical relevance because of a higher incidence of PGD and worse early survival, even though midterm survival is comparable. (C) 2016 by The Society of Thoracic Surgeons

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Soresi, SimonaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zeriouh, MohamedUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sabashnikov, AntonUNSPECIFIEDorcid.org/0000-0002-6289-1035UNSPECIFIED
Sarang, ZubairUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mohite, Prashant N.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Patil, Nikhil P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mansur, AshhamUNSPECIFIEDorcid.org/0000-0002-0322-2480UNSPECIFIED
Weymann, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wippermann, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wahlers, ThorstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reed, AnnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Carby, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Simon, Andre R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Popov, Aron-FrederikUNSPECIFIEDorcid.org/0000-0003-4226-3004UNSPECIFIED
URN: urn:nbn:de:hbz:38-273953
DOI: 10.1016/j.athoracsur.2015.11.068
Journal or Publication Title: Ann. Thorac. Surg.
Volume: 101
Number: 6
Page Range: S. 2112 - 2120
Date: 2016
Publisher: ELSEVIER SCIENCE INC
Place of Publication: NEW YORK
ISSN: 1552-6259
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
EXTRACORPOREAL MEMBRANE-OXYGENATION; BRONCHIOLITIS-OBLITERANS-SYNDROME; CYSTIC-FIBROSIS PATIENTS; ISHLT WORKING GROUP; RISK-FACTORS; INTERNATIONAL-SOCIETY; ADULT LUNG; SURVIVAL; REGISTRY; FAILUREMultiple languages
Cardiac & Cardiovascular Systems; Respiratory System; SurgeryMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/27395

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