Graft ischemic time and outcome of lung transplantation: a multicenter analysis.

Abstract:

RATIONALE:The effect of graft ischemic time on early graft function and long-term survival of patients who underwent lung transplantation remains controversial. Consequently, graft ischemic time has not been incorporated in the decision-making process at the time of graft acceptance. OBJECTIVES:To investigate the relationship between graft ischemic time and (1) early graft function and (2) long-term survival after lung transplantation. MEASUREMENTS AND MAIN RESULTS:The data from 752 patients who underwent single lung transplantation (n = 258), bilateral lung transplantation (n = 247), and heart-lung transplantation (n = 247) in seven French transplantation centers during a 12-year period were reviewed. Independent data quality control was done to ensure the quality of the collected variables. Mean graft ischemic time was 245.8 +/- 96.4 minutes (range 50-660). After adjustment on 11 potential confounders, graft ischemic time was associated with the recipient Pa(O2)/FI(O2) ratio recorded within the first 6 hours and with long-term survival in patients undergoing single or double lung transplantation but not in patients undergoing heart-lung transplantation. The relationship between graft ischemic time and survival appears to be of cubic form with a cutoff value of 330 minutes. These results were unaffected by the preservation fluid employed. CONCLUSIONS:The results of this large cohort of patients suggest a close relationship between graft ischemic time and both early gas exchange and long-term survival after single and double lung transplantation. Such relationship was not found in patients undergoing heart-lung transplantation. The expected graft ischemic time should be incorporated in the decision-making process at the time of graft acceptance.

authors

Thabut G,Mal H,Cerrina J,Dartevelle P,Dromer C,Velly JF,Stern M,Loirat P,Lesèche G,Bertocchi M,Mornex JF,Haloun A,Despins P,Pison C,Blin D,Reynaud-Gaubert M

doi

10.1164/rccm.200409-1248OC

keywords:

subject

Has Abstract

pub_date

2005-04-01 00:00:00

pages

786-91

issue

7

eissn

1073-449X

issn

1535-4970

pii

200409-1248OC

journal_volume

171

pub_type

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