| Low potassium dextran is superior to University of Wisconsin solution in high-risk lung transplant recipients. | |
| | |
MedLine Citation:
|
PMID: 20634098 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: The ideal solution for recovery of donor lungs remains unknown. Low potassium dextran (LPD) solution is most common, but University of Wisconsin (UW) solution is also used. The United Network for Organ Sharing (UNOS) database allows assessment of preservation solutions in a large cohort of lung transplant (LTx) patients. METHODS: We retrospectively reviewed the UNOS data set for adult primary LTx patients (2005-2008) whose donor lungs were recovered with UW or LPD solution. Patients were stratified by UW vs LPD, and secondarily grouped by quartiles of the lung allocation score (LAS) to examine high-risk recipients. Kaplan-Meier (KM) short-term mortality (30 days, 90 days, 1 year) and rejection in the first year were examined for intervals with adequate follow-up. Cox proportional hazard regression using 11 variables examined all cause 1-year mortality. RESULTS: Of 4,455 patients, 4,161 (93.4%) received LPD lungs and 294 (6.6%) received UW lungs, and 1,105 patients (24.8%) died during the study. There was no mortality difference based on flush solution with all patients examined together. However, patients in the upper 2 LAS quartiles (Q3: 37.8-45.4, Q4: > 45.4) receiving LPD lungs had greater 1-year survival of 81.5% vs 73.5% (p = 0.02). On multivariable analysis, flush with UW solution resulted in an increased risk of 1-year mortality (hazard ratio, 1.77. 95% confidence interval, 1.21-2.58; p = 0.003) vs LPD. Preservation solution did not affect rejection rates in the year after LTx. KM modeling demonstrated the effect of flush solution on survival (p = 0.02). CONCLUSIONS: This study is the largest modern cohort to evaluate the effect of donor lung flush solutions on survival in adult LTx. UW solution increases the risk of 1-year mortality in high-risk LTx recipients. |
| | |
Authors:
|
George J Arnaoutakis; Jeremiah G Allen; Christian A Merlo; William A Baumgartner; John V Conte; Ashish S Shah |
Related Documents
:
|
8832558 - Postmortem findings in lung transplant recipients. 8306738 - Utility of inhaled pentamidine prophylaxis in lung transplant recipients. 10391258 - Impact of graft ischemic time on outcomes after bilateral sequential single-lung transp... 7663808 - Inert gas single-breath washout after heart-lung transplantation. 11435738 - Effects of angiotensin ii and the at(1) receptor antagonist losartan on the renal excre... 17899978 - Ultrasonographic measurement of kidney-to-aorta ratio as a method of estimating renal s... |
Publication Detail:
|
Type: Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S. Date: 2010-07-14 |
Journal Detail:
|
Title: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation Volume: 29 ISSN: 1557-3117 ISO Abbreviation: J. Heart Lung Transplant. Publication Date: 2010 Dec |
Date Detail:
|
Created Date: 2010-11-24 Completed Date: 2011-03-16 Revised Date: 2011-08-01 |
Medline Journal Info:
|
Nlm Unique ID: 9102703 Medline TA: J Heart Lung Transplant Country: United States |
Other Details:
|
Languages: eng Pagination: 1380-7 Citation Subset: IM |
Copyright Information:
|
Copyright © 2010 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
|
Division of Cardiac Surgery, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adenosine Adult Aged Allopurinol Dextrans Female Follow-Up Studies Glucose Glutathione Humans Insulin Kaplan-Meier Estimate Lung* Lung Transplantation / mortality* Male Middle Aged Organ Preservation / methods* Organ Preservation Solutions* Raffinose Retrospective Studies Risk Assessment Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
|
231-00-0115//PHS HHS; 2T32DK007713-12/DK/NIDDK NIH HHS; T32 CA126607-01A2/CA/NCI NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Organ Preservation Solutions; 0/University of Wisconsin-lactobionate solution; 0/low potassium dextran glucose solution; 11061-68-0/Insulin; 315-30-0/Allopurinol; 50-99-7/Glucose; 512-69-6/Raffinose; 58-61-7/Adenosine; 70-18-8/Glutathione; 9004-54-0/Dextrans |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Hepatic encephalopathy with reversible focal neurologic signs resembling acute stroke: case report.
Next Document: Results of concomitant rotator cuff and SLAP repair are not affected by unhealed SLAP lesion.