Document Detail


Soluble p-selectin and the risk of primary graft dysfunction after lung transplantation.
MedLine Citation:
PMID:  19255296     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Platelet activation with subsequent neutrophilic adherence to the vasculature initiates ischemia-reperfusion injury. We hypothesized that higher plasma P-selectin levels reflecting platelet activation would therefore be associated with primary graft dysfunction (PGD) after lung transplantation.
METHODS: In a prospective, multicenter cohort study of 376 patients who had undergone lung transplantation between 2002 and 2007, we measured soluble P-selectin levels before lung transplantation and at 6 and 24 h after lung reperfusion in 20 patients with grade III PGD (Pao(2)/fraction of inspired oxygen, < 200 mm Hg [with alveolar infiltrates seen on chest radiographs]) at 72 h after transplantation and 61 control subjects without PGD.
RESULTS: Higher postoperative soluble P-selectin levels were associated with an increased risk of PGD at 72 h after transplantation (odds ratio [OR] per 1 natural log increase in soluble P-selectin at 6 h after lung allograft reperfusion, 3.5; 95% confidence interval [CI], 1.01 to 11.8; p = 0.048) and at 24 h after lung allograft reperfusion (OR, 4.8; 95% CI, 1.4 to 16.1; p = 0.01). Higher preoperative mean pulmonary artery pressure and the use of cardiopulmonary bypass were also associated with an increased risk of PGD.
CONCLUSION: Higher postoperative soluble P-selectin levels were associated with an increased risk of PGD at 72 h following lung transplantation.
Authors:
Steven M Kawut; Jeffrey Okun; Daichi Shimbo; David J Lederer; Joao De Andrade; Vibha Lama; Ashish Shah; Aaron Milstone; Lorraine B Ware; Ann Weinacker; Ejigayehu Demissie; Jason D Christie;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural     Date:  2009-03-02
Journal Detail:
Title:  Chest     Volume:  136     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-08     Completed Date:  2009-08-05     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  237-44     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Cardiovascular Institute, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. kawut@mail.med.upenn.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Case-Control Studies
Cohort Studies
Female
Humans
Logistic Models
Lung Diseases / blood*,  pathology,  surgery
Lung Transplantation / adverse effects*
Male
Middle Aged
P-Selectin / blood*
Platelet Activation
Primary Graft Dysfunction / blood*,  etiology*
Risk Factors
Grant Support
ID/Acronym/Agency:
HL04243/HL/NHLBI NIH HHS; HL067771/HL/NHLBI NIH HHS; HL081332/HL/NHLBI NIH HHS; HL081619/HL/NHLBI NIH HHS; HL087115/HL/NHLBI NIH HHS; K23 HL067771-01/HL/NHLBI NIH HHS; K23 HL067771-02/HL/NHLBI NIH HHS; K23 HL067771-03/HL/NHLBI NIH HHS; K23 HL067771-04/HL/NHLBI NIH HHS; K23 HL067771-05/HL/NHLBI NIH HHS; K23 HL067771-06/HL/NHLBI NIH HHS; L30 HL086095-01/HL/NHLBI NIH HHS; L30 HL086095-02/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/P-Selectin
Comments/Corrections

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