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Risk factors and outcome of primary graft dysfunction after lung transplantation in Korea

 Sungwoo Moon  ;  Moo Suk Park  ;  Jin Gu Lee  ;  Ji Ye Jung  ;  Young Ae Kang  ;  Young Sam Kim  ;  Se Kyu Kim  ;  Joon Chang  ;  Hyo Chae Paik  ;  Song Yee Kim 
 Journal of Thoracic Disease, Vol.8(11) : 3275-3282, 2016 
Journal Title
 Journal of Thoracic Disease 
Issue Date
BACKGROUND: Primary graft dysfunction (PGD) is a severe, acute and post-transplantation lung injury associated with early morbidity and mortality. We aimed to identify clinical risk factors for PGD, as well as the outcome of PGD after lung transplantation in Korea. METHODS: We retrospectively analyzed lung transplant patients in a South Korean Hospital. The primary outcome was grade 3 PGD, defined according to the International Society for Heart and Lung Transplantation criteria. We compared grade 0-2 PGD group to grade 3 PGD group to identify the risk factors and outcome of grade 3 PGD. RESULTS: Sixty-one patients were enrolled; 16 (26.2%) developed grade 3 PGD. Univariate analysis revealed higher body mass index (BMI) and history of smoking, extracorporeal membrane oxygenation (ECMO) before transplantation in recipients, and an extended intraoperative ischemic time as risk factors for grade 3 PGD. In multivariate analysis, independent risk factors for PGD were higher BMI in recipients [odds ratio (OR), 1.286; P=0.043] and total intraoperative ischemic time (OR, 1.028; P=0.007). As compared to grade 0-2 PGD, grade 3 PGD was significantly associated with a higher re-operation rate (grade 0-2 PGD vs. grade 3 PGD, 22.2% vs. 50.0%; P=0.036), prolonged ventilator apply (median: 6.0 vs. 14.5 days; P=0.044), a longer intensive care unit stay (median: 9.0 vs. 17.0 days; P=0.041), and a higher rate of renal replacement therapy (RRT) (17.8% vs. 62.5%; P=0.002) after transplantation. CONCLUSIONS: Patients who developed grade 3 PGD had higher re-operation rate, longer ventilator apply, longer intensive care unit stay, higher rate of RRT, with higher BMI and total intraoperative ischemic time being the significant risk factor. These findings may allow physicians to modify risk factors before development of PGD.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
강영애(Kang, Young Ae) ORCID logo https://orcid.org/0000-0002-7783-5271
김세규(Kim, Se Kyu)
김송이(Kim, Song Yee) ORCID logo https://orcid.org/0000-0001-8627-486X
김영삼(Kim, Young Sam) ORCID logo https://orcid.org/0000-0001-9656-8482
문성우(Moon, Sung Woo) ORCID logo https://orcid.org/0000-0001-9917-9802
박무석(Park, Moo Suk) ORCID logo https://orcid.org/0000-0003-0820-7615
백효채(Paik, Hyo Chae) ORCID logo https://orcid.org/0000-0001-9309-8235
이진구(Lee, Jin Gu)
장준(Chang, Joon) ORCID logo https://orcid.org/0000-0003-4542-6841
정지예(Jung, Ji Ye) ORCID logo https://orcid.org/0000-0003-1589-4142
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