Document Detail


Lung Transplantation for Patients With High Lung Allocation Score: Single-Center Experience.
MedLine Citation:
PMID:  22192755     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The lung allocation score (LAS) assigns organ allocation priority based on medical urgency and the likelihood of posttransplant survival. This study is a review of a single institutional experience for lung transplantation in the era of LAS. METHODS: We performed a retrospective review of 527 consecutive patients, from May 2005 to February 2010, who underwent lung transplant at our institution, comprising a high LAS group (LAS ≥ 50, n = 108) and a low LAS group (LAS < 50, n = 419). Kaplan-Meier and univariate analyses were performed to assess postoperative mortality as a primary outcome, and length of ventilator support and intensive care unit stay as secondary outcomes. Risk factors, including demographics, pulmonary status, and surgical and donor variables, were compared. Predictors of mortality were determined using a Cox proportional hazard model. RESULTS: Survivals after 30 days, 90 days, 1 year, and 3 years were 92.6%, 87.8%, 71.5%, and 52.0%, respectively, in the high LAS group, and 96.9%, 93.5%, 83.2%, and 73.9% in the low LAS group (p < 0.001). The incidence of prolonged ventilator support and the need for tracheostomy were higher, and intensive care unit stay was longer in the high LAS group. In the high LAS group, ischemic time greater than 8 hours was an independent predictor for mortality (hazard ratio: 3.080; 95% confidence interval 1.101 to 8.161, p = 0.032). CONCLUSIONS: Lung transplant in patients with high a LAS is associated with significantly decreased survival and increased complications compared with patients with a low LAS. Ischemic time greater than 8 hours is a significant predictor of death in patients with a high LAS.
Authors:
Tetsuya Horai; Norihisa Shigemura; Cynthia Gries; Joseph Pilewski; Jay K Bhama; Christian A Bermudez; Diana Zaldonis; Yoshiya Toyoda
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-20
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  -     ISSN:  1552-6259     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Division of Cardiothoracic Transplantation, Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
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