Influencing factors of survival of patients with airway stenosis requiring clinical interventions after lung transplantation
10.3969/j.issn.1674-7445.2023236
- VernacularTitle:肺移植术后需要临床干预的气道狭窄患者生存结局的影响因素
- Author:
Lingzhi SHI
1
;
Heng HUANG
2
,
3
;
Mingzhao LIU
1
;
Hang YANG
1
;
Bo WU
1
;
Jin ZHAO
1
;
Haoji YAN
3
;
Yujie ZUO
3
;
Xinyue ZHANG
3
;
Linxi LIU
3
;
Dong TIAN
2
,
3
;
Jingyu CHEN
3
,
4
Author Information
1. Wuxi Medical Center, Nanjing Medical University, Wuxi People's Hospital, Department of Lung Transplant Center, the Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China.
2.
3. .
4. Wuxi Medical Center, Nanjing Medical University, Wuxi People's Hospital, Department of Lung Transplant Center, the Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China
- Publication Type:OriginalArticle
- Keywords:
Lung transplantation;
Airway stenosis;
Airway complication;
Primary graft dysfunction (PGD);
Acute rejection;
Extracorporeal membrane oxygenation;
Oxygenation index;
Mechanical ventilation;
Single lung transplantation;
Bilateral lung transplantation
- From:
Organ Transplantation
2024;15(2):236-243
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the influencing factors of survival of patients with airway stenosis requiring clinical interventions after lung transplantation. Methods Clinical data of 66 patients with airway stenosis requiring clinical interventions after lung transplantation were retrospectively analyzed. Univariate and multivariate Cox’s regression models were adopted to analyze the influencing factors of survival of all patients with airway stenosis and those with early airway stenosis. Kaplan-Meier method was used to calculate the overall survival and delineate the survival curve. Results For 66 patients with airway stenosis, the median airway stenosis-free time was 72 (52,102) d, 27% (18/66) for central airway stenosis and 73% (48/66) for distal airway stenosis. Postoperative mechanical ventilation time [hazard ratio (HR) 1.037, 95% confidence interval (CI) 1.005-1.070, P=0.024] and type of surgery (HR 0.400, 95%CI 0.177-0.903, P=0.027) were correlated with the survival of patients with airway stenosis after lung transplantation. The longer the postoperative mechanical ventilation time, the higher the risk of mortality of the recipients. The overall survival of airway stenosis recipients undergoing bilateral lung transplantation was better than that of their counterparts after single lung transplantation. Subgroup analysis showed that grade 3 primary graft dysfunction (PGD) (HR 4.577, 95%CI 1.439-14.555, P=0.010) and immunosuppressive drugs (HR 0.079, 95%CI 0.022-0.287, P<0.001) were associated with the survival of patients with early airway stenosis after lung transplantation. The overall survival of patients with early airway stenosis after lung transplantation without grade 3 PGD was better compared with that of those with grade 3 PGD. The overall survival of patients with early airway stenosis after lung transplantation treated with tacrolimus was superior to that of their counterparts treated with cyclosporine. Conclusions Long postoperative mechanical ventilation time, single lung transplantation, grade 3 PGD and use of cyclosporine may affect the survival of patients with airway stenosis after lung transplantation.
