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Perioperative factors associated with 1-year mortality after lung transplantation: a single-center experience in Korea
- Perioperative factors associated with 1-year mortality after lung transplantation: a single-center experience in Korea
- Lee, Su Hwan; Park, Moo Suk; Song, Joo Han; Kim, Young Sam; Lee, Jin Gu; Paik, Hyo Chae; Kim, Song Yee
- Ewha Authors
- Issue Date
- Journal Title
- JOURNAL OF THORACIC DISEASE
- 2072-1439; 2077-6624
- vol. 9, no. 10, pp. 4006 - 4016
- Lung transplantation; mortality; risk factors; acute kidney injury (AKI); aging
- AME PUBL CO
- SCIE; SCOPUS
- Background: Most studies about the risk factors of 1-year mortality after lung transplantation were performed on non-Asians. This study aimed to evaluate the perioperative factors related to the 1-year mortality after lung transplantation in Korea. Methods: Sixty-eight consecutive patients who underwent lung transplantation without preoperative extracorporeal membrane oxygenation treatment at 1 tertiary hospital in South Korea between October 24, 2012, and October 16, 2015, were analyzed retrospectively. Results: Forty-four patients (64.7%) lived for >1 year after lung transplantation. The median age of all patients was 55 years (range, 16-75 years), and men accounted for 57.4%. The major cause of lung transplantation was idiopathic pulmonary fibrosis (48.5%); the other causes were interstitial lung disease related to connective tissue disease (17.6%) and bronchiolitis obliterans after stem cell transplantation (14.7%). In univariate analysis, higher median age (52 vs. 61.5 years, P<0.001), male sex (45.5% vs. 79.2%, P=0.007), lower preoperative albumin level (<3 g/dL) (22.7% vs. 45.8%, P=0.049), need for renal replacement therapy (RRT) after surgery (4.5% vs. 37.5%, P=0.001), and postoperative delta neutrophil index (DNI)>5.5 higher than the preoperative DNI (22.7% vs. 70.8%, P<0.001) were significantly related to 1-year mortality. After adjustments, old age, postoperative increased DNI, and need for RRT after transplantation were the independent perioperative risk factors for 1-year mortality after lung transplantation. Conclusions: Recipients with advanced age should be carefully selected, and patients who need RRT or with increased DNI after transplantation should be managed accordingly.
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