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Effects of intraoperative inhaled iloprost on primary graft dysfunction after lung transplantation: A retrospective single center study

Authors
 Su Hyun Lee  ;  Jin Gu Lee  ;  Chang Yeong Lee  ;  Namo Kim  ;  Min-Yung Chang  ;  Young-Chul You  ;  Hyun Joo Kim  ;  Hyo Chae Paik  ;  Young Jun Oh 
Citation
 MEDICINE, Vol.95(27) : 3975, 2016 
Journal Title
 MEDICINE 
ISSN
 0025-7974 
Issue Date
2016
MeSH
Administration, Inhalation ; Adult ; Female ; Humans ; Iloprost/administration & dosage* ; Intraoperative Care* ; Lung Transplantation* ; Male ; Primary Graft Dysfunction/prevention & control* ; Retrospective Studies ; Vasodilator Agents/administration & dosage*
Keywords
iloprost ; lung transplantation ; primary graft dysfunction
Abstract
DESIGN: Inhaled iloprost was known to alleviate ischemic-reperfusion lung injury. We investigated whether intraoperative inhaled iloprost can prevent the development of primary graft dysfunction after lung transplantation. Data for a consecutive series of patients who underwent lung transplantation with extracorporeal membrane oxygenation were retrieved. By propensity score matching, 2 comparable groups of 30 patients were obtained: patients who inhaled iloprost immediately after reperfusion of the grafted lung (ILO group); patients who did not receive iloprost (non-ILO group). RESULTS: The severity of pulmonary infiltration on postoperative days (PODs) 1 to 3 was significantly lower in the ILO group compared to the non-ILO group. The PaO2/FiO2 ratio was significantly higher in the ILO group compared to the non-ILO group (318.2 ± 74.2 vs 275.9 ± 65.3?mm Hg, P = 0.022 on POD 1; 351.4 ± 58.2 vs 295.8 ± 53.7?mm Hg, P = 0.017 on POD 2; and 378.8 ± 51.9 vs 320.2 ± 66.2?mm Hg, P = 0.013 on POD 3, respectively). The prevalence of the primary graft dysfunction grade 3 was lower in the ILO group compared to the non-ILO group (P = 0.042 on POD 1; P = 0.026 on POD 2; P = 0.024 on POD 3, respectively). The duration of ventilator use and intensive care unit were significantly reduced in the ILO group (P = 0.041 and 0.038). CONCLUSIONS: Intraoperative inhaled iloprost could prevent primary graft dysfunction and preserve allograft function, thus reducing the length of ventilator care and intensive care unit stay, and improving the overall early post-transplant morbidity in patients undergoing lung transplantation.
DOI
10.1097/MD.0000000000003975
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Namo(김남오) ORCID logo https://orcid.org/0000-0002-0829-490X
Kim, Hyun Joo(김현주) ORCID logo https://orcid.org/0000-0003-1963-8955
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Oh, Young Jun(오영준) ORCID logo https://orcid.org/0000-0002-6258-5695
Yoo, Young Chul(유영철) ORCID logo https://orcid.org/0000-0002-6334-7541
Lee, Su Hyun(이수현)
Lee, Jin Gu(이진구)
Lee, Chang Young(이창영)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151646
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