TY - JOUR
T1 - Definitions of primary graft dysfunction after lung transplantation
T2 - Differences between bilateral and single lung transplantation
AU - Oto, Takahiro
AU - Griffiths, Anne P.
AU - Levvey, Bronwyn J.
AU - Pilcher, David V.
AU - Williams, Trevor J.
AU - Snell, Gregory I.
N1 - Funding Information:
The prevalence of PGD grade between BLT and SLT is different. The incidence of grade 3 PGD varies over time in both transplantation types, always tending to be more common in SLT. The current definition of PGD in BLT and SLT appears to have clinical utility in both transplantation types because the PGD grade correlated with the early posttransplantation outcomes in both BLT and SLT. However, for the purposes of description and further studies, the incidence of the various PGD grades in BLT and SLT should be considered separately. We thank Sharon Daly for assembling and verifying the clinical data, and we also wish to extend our appreciation to members of the Heart and Lung Transplant Service, The Alfred Hospital for their assistance, and the Margaret Pratt Foundation and the Alfred Foundation for their financial support. Bronwyn J. Levvey, RN, Trevor J. Williams, FRACP, Takahiro Oto, MD, Gregory I. Snell, FRACP, and Anne P. Griffiths, FRCNA ( left to right )
PY - 2006/7
Y1 - 2006/7
N2 - Objective: The primary graft dysfunction definition has been applied to both bilateral lung transplantation and single lung transplantation. However, the differences between bilateral and single lung transplantation in terms of primary graft dysfunction remain unknown. This study aims to investigate the features and utility of the new primary graft dysfunction grading system by comparing early outcomes from bilateral and single lung transplantation. Methods: The primary graft dysfunction grade of 228 consecutive lung transplants (149 bilateral and 79 single lung transplants) at multiple postoperative time points was analyzed. Subgroup analysis with chronic obstructive pulmonary disease was performed to further validate the difference between bilateral lung transplantation and single lung transplantation. Results: The percentage of grade 3 primary graft dysfunction in bilateral and single lung transplants was 32% and 37% at 0 hours (T0), 9% and 33% at 12 hours (T12), 7% and 26% at 24 hours (T24), and 9% and 18% at 72 hours (T72), respectively. The prevalence of the grade 3 primary graft dysfunction (T24) was significantly different between those undergoing bilateral lung transplantation and those undergoing single lung transplantation (P = .02). The primary graft dysfunction grade (T0) significantly correlated with the duration of intubation in both bilateral (r = 0.35, P < .0001) and single (r = 0.42, P = .001) lung transplantation and length of intensive care unit stay in both bilateral (r = 0.31, P = .0002) and single (r = 0.33, P = .006) lung transplantation. These differences were validated by the subgroup analysis. Conclusions: The prevalence of primary graft dysfunction grade is different between bilateral and single lung transplantation and varies with time. Although the primary graft dysfunction grade correlated with the early posttransplantation outcomes, for the purposes of description and further studies, primary graft dysfunction in bilateral and single lung transplantation should be considered separately.
AB - Objective: The primary graft dysfunction definition has been applied to both bilateral lung transplantation and single lung transplantation. However, the differences between bilateral and single lung transplantation in terms of primary graft dysfunction remain unknown. This study aims to investigate the features and utility of the new primary graft dysfunction grading system by comparing early outcomes from bilateral and single lung transplantation. Methods: The primary graft dysfunction grade of 228 consecutive lung transplants (149 bilateral and 79 single lung transplants) at multiple postoperative time points was analyzed. Subgroup analysis with chronic obstructive pulmonary disease was performed to further validate the difference between bilateral lung transplantation and single lung transplantation. Results: The percentage of grade 3 primary graft dysfunction in bilateral and single lung transplants was 32% and 37% at 0 hours (T0), 9% and 33% at 12 hours (T12), 7% and 26% at 24 hours (T24), and 9% and 18% at 72 hours (T72), respectively. The prevalence of the grade 3 primary graft dysfunction (T24) was significantly different between those undergoing bilateral lung transplantation and those undergoing single lung transplantation (P = .02). The primary graft dysfunction grade (T0) significantly correlated with the duration of intubation in both bilateral (r = 0.35, P < .0001) and single (r = 0.42, P = .001) lung transplantation and length of intensive care unit stay in both bilateral (r = 0.31, P = .0002) and single (r = 0.33, P = .006) lung transplantation. These differences were validated by the subgroup analysis. Conclusions: The prevalence of primary graft dysfunction grade is different between bilateral and single lung transplantation and varies with time. Although the primary graft dysfunction grade correlated with the early posttransplantation outcomes, for the purposes of description and further studies, primary graft dysfunction in bilateral and single lung transplantation should be considered separately.
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U2 - 10.1016/j.jtcvs.2006.03.029
DO - 10.1016/j.jtcvs.2006.03.029
M3 - Article
C2 - 16798314
AN - SCOPUS:33745191234
SN - 0022-5223
VL - 132
SP - 140-147.e2
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
IS - 1
ER -