Effects of secondary pulmonary hypertension on lung transplant outcomes
10.3760/cma.j.cn421203-20200128-00021
- VernacularTitle:继发性肺动脉高压对肺移植受者预后的影响
- Author:
Hanning ZHA
1
;
Xiaoshan LI
;
Yanhu XIE
;
Xiaoqing CHAI
;
Min ZHANG
;
Chuanyao LI
;
Li KE
;
Jingyu CHEN
;
Chunxiao HU
Author Information
1. 中国科学技术大学附属第一医院（安徽省立医院）麻醉科，合肥 230001
- From:
Chinese Journal of Organ Transplantation
2020;41(6):323-327
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effects of secondary pulmonary hypertension(SPH)on postoperative outcomes of lung transplant recipients.Methods:The hospitalization data of 309 patients undergoing lung transplant were retrospectively analyzed. They were divided into normal(mPAP <25 mmHg, 56 cases), low-pressure(mPAP: 25 mmHg≤mPAP<40 mmHg, 155 cases)and high pressure(mPAP ≥40 mmHg, 98 cases)groups.Three groups were compared with regards to general profiles, intraoperative status, postoperative outcomes and survival rates. The postoperative patient survival was plotted by Kaplan-Meier curve and log-rank test performed. Multivariate Cox regression analysis was performed to explore the influencing factors of postoperative survival.Results:The distribution of chronic lung disease(CLD)was statistically different among 3 groups( χ2=30.837, P=0.001). Patients with different levels of pulmonary artery pressure had different decisions supported intraoperatively by extracorporeal membrane oxygenation(ECMO)( χ2=28.205, P<0.001). The 2-year survival rates of normal, low-pressure and high-pressure groups were 58.9 %, 63.9 % and 69.4 % respectively and there were no statistically significant differences( P=0.513). Multivariate Cox regression analysis indicated that preoperative cardiac function was an independent risk factor for postoperative survival. The postoperative risk of mortality was 1.796 (95 %CI: 1.078~2.991)folds higher in patients with cardiac function grade Ⅲ/Ⅳ than those with grade Ⅰ/Ⅱ( P=0.025). Conclusions:Preoperative classification of cardiac function should be emphasized in SPH patients. And surgery during early decompensated stage of cardiac function may confer a better survival.
