scholarly journals The influence of the native lung on early outcomes and survival after single lung transplantation

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249758
Author(s):  
Francisco Javier Gonzalez ◽  
Enriqueta Alvarez ◽  
Paula Moreno ◽  
David Poveda ◽  
Eloisa Ruiz ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Late Complications ◽  
Short Term ◽  
Single Lung Transplantation ◽  
Copd Patients ◽  
Native Lung ◽  
Multivariable Analyses ◽  
Lung Transplants ◽  
Transplant Procedure

Objective To determine whether problems arising in the native lung may influence the short-term outcomes and survival after single lung transplantation (SLT), and therefore should be taken into consideration when selecting the transplant procedure. Patients and methods Retrospective review of 258 lung transplants performed between June 2012 and June 2019. Among them, 161 SLT were selected for the analysis. Complications in the native lung were recorded and distributed into two groups: early and late complications (within 30 days or after 30 days post-transplant). Donor and recipient preoperative factors, 30-day mortality and survival were analysed and compared between groups by univariable and multivariable analyses, and adjusting for transplant indication. Results There were 161 patients (126M/35F; 57±7 years) transplanted for emphysema (COPD) (n = 72), pulmonary fibrosis (IPF) (n = 77), or other indications (n = 12). Forty-nine patients (30%) presented complications in the native lung. Thirty-day mortality did not differ between patients with or without early complications (6% vs. 12% respectively; p = 0.56). Twelve patients died due to a native lung complication (7.4% of patients; 24% of all deaths). Survival (1,3,5 years) without vs. with late complications: COPD (89%, 86%, 80% vs. 86%, 71%, 51%; p = 0.04); IPF (83%, 77%, 72% vs. 93%, 68%, 58%; p = 0.65). Among 30-day survivors: COPD (94%, 91%, 84% vs. 86%, 71%, 51%; p = 0.01); IPF (93%, 86%, 81% vs. 93%, 68%, 58%; p = 0.19). Native lung complications were associated to longer ICU stay (10±17 vs. 33±96 days; p<0.001), longer postoperative intubation (41±85 vs. 99±318 hours; p = 0.006), and longer hospital stay (30±24 vs. 45±34 days; p = 0.03). The presence of late native lung problems predicted survival in COPD patients (OR: 2.55; p = 0.07). Conclusion The native lung is a source of morbidity in the short-term and mortality in the long-term after lung transplantation. This should be taken into consideration when choosing the transplant procedure, especially in COPD patients.

Thoracoscopic Volume Reduction of the Native Lung after Single Lung Transplantation for Emphysema

1998 ◽  
Vol 157 (1) ◽  
pp. 292-293 ◽  
Author(s):  
FEDERICO VENUTA ◽  
TIZIANO DE GIACOMO ◽  
ERINO A. RENDINA ◽  
GIORGIO DELLA ROCCA ◽  
ISAC FLAISHMAN ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Volume Reduction ◽  
Single Lung Transplantation ◽  
Native Lung

Infection in the Transplanted and Native Lung After Single Lung Transplantation

CHEST Journal ◽  
1993 ◽  
Vol 104 (3) ◽  
pp. 681-685 ◽  
Author(s):  
Joseph Horvath ◽  
Stephen Dummer ◽  
James Loyd ◽  
Beverly Walker ◽  
Walter H. Merrill ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Single Lung Transplantation ◽  
Native Lung

scholarly journals Exacerbation of Pulmonary Fibrosis Following Single Lung Transplantation

2012 ◽  
Vol 19 (1) ◽  
pp. e3-e4 ◽  
Author(s):  
Dawei Yang ◽  
Jennifer M Wilson ◽  
Chunxue Bai ◽  
John Yee ◽  
Pearce G Wilcox ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Fibrosis ◽  
Lung Transplantation ◽  
Lung Disease ◽  
Acute Exacerbation ◽  
Thromboembolic Disease ◽  
Single Lung Transplantation ◽  
Maintenance Immunosuppression ◽  
Native Lung ◽  
Acute Exacerbations

Acute exacerbations of interstitial lung disease present as clinical deteriorations, with progressive hypoxemia and parenchymal consolidation not related to infection, heart failure or thromboembolic disease. Following single lung transplantation, patients receive maintenance immunosuppression, which could mitigate the development of acute exacerbations in the native lung. A 66-year-old man with fibrotic, nonspecific interstitial pneumonitis presented with fever, hypoxemia and parenchymal consolidation limited to the native lung four years after single lung transplantation. Investigations were negative for infection, heart failure and thromboembolic disease. The patient worsened over the course of one week despite broad-spectrum antimicrobial therapy, but subsequently improved promptly with augmentation of prednisone dosed to 50 mg daily and addition of N-acetylcysteine. Hence, the patient fulfilled the criteria for a diagnosis of an acute exacerbation of pulmonary fibrosis in his native lung. Clinicians should consider acute exacerbation of parenchymal lung disease of the native lung in the differential diagnosis of progressive respiratory deterioration following single lung transplantation for pulmonary fibrosis.

Spontaneous Pneumothorax in the Native Lung After Single Lung Transplantation

2004 ◽  
Vol 11 (3) ◽  
pp. 175-177
Author(s):  
Daniel Starobin ◽  
Amihai Rubin ◽  
Alon Yellin ◽  
Gershon Fink ◽  
Mordechai R Kramer
Keyword(s):  
Lung Transplantation ◽  
Spontaneous Pneumothorax ◽  
Single Lung Transplantation ◽  
Native Lung

Volume of Graft and Native Lung after Single-Lung Transplantation for Emphysema

1999 ◽  
Vol 159 (2) ◽  
pp. 641-645 ◽  
Author(s):  
MARC ESTENNE ◽  
MARIE CASSART ◽  
PHILIPPE PONCELET ◽  
PIERRE ALAIN GEVENOIS
Keyword(s):  
Lung Transplantation ◽  
Single Lung Transplantation ◽  
Native Lung

Association of adrenal hormone metabolites and mortality over a 6-year follow-up in COPD patients with acute exacerbation

2018 ◽  
Vol 56 (4) ◽  
pp. 669-680 ◽  
Author(s):  
Seline Zurfluh ◽  
Manuela Nickler ◽  
Manuel Ottiger ◽  
Christian Steuer ◽  
Alexander Kutz ◽  
...  
Keyword(s):  
Cox Regression ◽  
Time Dependent ◽  
Chronic Obstructive ◽  
Short Term ◽  
Therapeutic Implications ◽  
Adrenal Hormone ◽  
Copd Patients ◽  
Short And Long Term ◽  
Long Term Mortality

Abstract Background: The release of hormones from the adrenal gland is vital in acute and chronic illnesses such as chronic obstructive pulmonary disease (COPD) involving recurrent exacerbations. Using a metabolomic approach, we aim to investigate associations of different adrenal hormone metabolites with short- and long-term mortality in COPD patients. Methods: We prospectively followed 172 COPD patients (median age 75 years, 62% male) from a previous Swiss multicenter trial. At baseline, we measured levels of a comprehensive spectrum of adrenal hormone metabolites, including glucocorticoid, mineralocorticoid and androgen hormones by liquid chromatography coupled with tandem mass spectrometry (MS). We calculated Cox regression models adjusted for gender, age, comorbidities and previous corticosteroid therapy. Results: Mortality was 6.4% after 30 days and increased to 61.6% after 6 years. Higher initial androgen hormones predicted lower long-term mortality with significant results for dehydroepiandrosterone (DHEA) [adjusted hazard ratio (HR), 0.82; 95% confidence interval (CI), 0.70–0.98; p=0.026] and dehydroepiandrosterone sulfate (DHEA-S) (adjusted HR, 0.68; 95% CI, 0.50–0.91; p=0.009). An activation of stress hormones (particularly cortisol and cortisone) showed a time-dependent effect with higher levels pointing towards higher mortality at short term, but lower mortality at long term. Activation of the mineralocorticoid axis tended to be associated with increased short-term mortality (adjusted HR of aldosterone, 2.76; 95% CI, 0.79–9.65; p=0.111). Conclusions: Independent of age, gender, corticosteroid exposure and exacerbation type, adrenal hormones are associated with mortality at short and long term in patients with COPD exacerbation with different time-dependent effects of glucocorticoids, androgens and mineralocorticoids. A better physiopathological understanding of the causality of these effects may have therapeutic implications.

Sign in / Sign up

Export Citation Format

Share Document