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Clinical Outcomes of Lung Transplants From Donors With Unexpected Pulmonary Embolism.
- Source :
- Annals of Thoracic Surgery; Aug2021, Vol. 112 Issue 2, p387-394, 8p
- Publication Year :
- 2021
-
Abstract
- Pulmonary embolism (PE) is unexpectedly detected in some donor lungs during organ procurement for lung transplantation. Anecdotally, such lungs are usually implanted; however, the impact of this finding on recipient outcomes remains unclear. We hypothesized that incidentally detected donor PE is associated with adverse short-term and long-term outcomes among lung transplant recipients. We analyzed a prospectively maintained database of all lung donors procured by a single surgeon and transplanted at our institution between 2009 and 2018. A standardized approach was used for all procurements and included antegrade and retrograde flush. Pulmonary embolism was defined as macroscopic thrombus seen in the pulmonary artery during the donor procurement operation. A total of 501 consecutive lung procurements were performed during the study period. The incidence of donor PE was 4.4% (22 of 501). No organs were discarded owing to PE. Donors with PE were similar to donors without PE in baseline characteristics and Pa o 2. Recipients in the two groups were also similar. Pulmonary embolism was associated with a higher likelihood of acute cellular rejection grade 2 or more (10 of 22 [45.5%] vs 120 of 479 [25.1%], P =.03). Multivariable Cox modeling demonstrated an association between PE and the development of chronic lung allograft dysfunction (hazard ratio 2.02; 95% confidence interval, 1.23 to 3.30; P =.005). Lungs from donors with incidentally detected PE may be associated with a higher incidence of recipient acute cellular rejection as well as reduced chronic lung allograft dysfunction-free survival. Surgeons must use caution when transplanting lungs with incidentally discovered PE. These preliminary findings warrant corroboration in larger data sets. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00034975
- Volume :
- 112
- Issue :
- 2
- Database :
- Supplemental Index
- Journal :
- Annals of Thoracic Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 151555370
- Full Text :
- https://doi.org/10.1016/j.athoracsur.2020.08.040