Effect of prolonged cold ischemia time on outcomes after lung transplantation
10.3760/cma.j.cn421203-20220521-00118
- VernacularTitle:供肺冷缺血时间对肺移植预后影响的临床观察
- Author:
Yuping LI
1
;
Jie DAI
;
Xiaogang LIU
;
Wenxin HE
;
Chang CHEN
;
Yuming ZHU
;
Gening JIANG
Author Information
1. 同济大学附属上海市肺科医院胸外科，上海 200433
- Keywords:
Lung transplantation;
Cold ischemic time;
Survival rate
- From:
Chinese Journal of Organ Transplantation
2022;43(9):530-535
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of prolonged graft cold ischemia time(CIT)on outcomes of lung transplantation(LTx).Methods:Clinical data are retrospectively reviewed for 111 patients undergoing LTx at Affiliated Shanghai Pulmonary Hospital of Tongji University between January 2019 and January 2022. They are divided into two groups of prolonged CIT(8~12 h, 41 cases)and control(<8 h, 70 cases)according to CIT. Kaplan-Meier method is employed for estimating 1-year cumulative survival rate and multivariable Cox proportional hazard regression model for identifying independent risk factors of 1-year mortality.Results:No significant inter-group difference existed in the incidence of primary graft dysfunction grade Ⅲ within the first 72 h post-LTx(21.2% vs. 16.3%). The 30-day(90.2% vs. 94.3%)and 90-day(82.9% vs. 82.9%)survival rates are comparable between two groups. Similarly 1-year cumulative survival is also comparable between two groups (74.6% vs. 60.4%, Log-rank P=0.279). Multivariate Cox regression analysis indicated that prolonged CIT was not associated with an elevated risk of 1-year mortality( HR 0.691; 95% CI: 0.317~1.506). However, an absence of ECMO support during surgery( HR 3.562; 95% CI: 1.061~11.959)and postoperative mechanical ventilation for >3 days(HR 2.892; 95% CI: 1.387~6.031)elevate 1-year risk of mortality. Conclusions:Prolongation of CIT to 8~12 h has no adverse effect on the prognosis of recipients. Given a great scarcity of donor lungs and a growing number of LTx candidates, it is reasonable to accept prolonged CIT donor lungs for clinical LTx.
