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Perioperative factors associated with 1-year mortality after lung transplantation: a single-center experience in Korea

Authors
 Su Hwan Lee  ;  Moo Suk Park  ;  Joo Han Song  ;  Young Sam Kim  ;  Jin Gu Lee  ;  Hyo Chae Paik  ;  Song Yee Kim 
Citation
 Journal of Thoracic Disease, Vol.9(10) : 4006-4016, 2017 
Journal Title
 Journal of Thoracic Disease 
ISSN
 2072-1439 
Issue Date
2017
Keywords
Lung transplantation ; acute kidney injury (AKI) ; aging ; mortality ; risk factors
Abstract
Background: Most studies about the risk factors of 1-year mortality after lung transplantation were performed on non-Asians. This study aimed to evaluate the perioperative factors related to the 1-year mortality after lung transplantation in Korea. Methods: Sixty-eight consecutive patients who underwent lung transplantation without preoperative extracorporeal membrane oxygenation treatment at 1 tertiary hospital in South Korea between October 24, 2012, and October 16, 2015, were analyzed retrospectively. Results: Forty-four patients (64.7%) lived for >1 year after lung transplantation. The median age of all patients was 55 years (range, 16-75 years), and men accounted for 57.4%. The major cause of lung transplantation was idiopathic pulmonary fibrosis (48.5%); the other causes were interstitial lung disease related to connective tissue disease (17.6%) and bronchiolitis obliterans after stem cell transplantation (14.7%). In univariate analysis, higher median age (52 vs. 61.5 years, P<0.001), male sex (45.5% vs. 79.2%, P=0.007), lower preoperative albumin level (<3 g/dL) (22.7% vs. 45.8%, P=0.049), need for renal replacement therapy (RRT) after surgery (4.5% vs. 37.5%, P=0.001), and postoperative delta neutrophil index (DNI) >5.5 higher than the preoperative DNI (22.7% vs. 70.8%, P<0.001) were significantly related to 1-year mortality. After adjustments, old age, postoperative increased DNI, and need for RRT after transplantation were the independent perioperative risk factors for 1-year mortality after lung transplantation. Conclusions: Recipients with advanced age should be carefully selected, and patients who need RRT or with increased DNI after transplantation should be managed accordingly.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161557
Files in This Item:
T201705205.pdf Download
DOI
10.21037/jtd.2017.09.21
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실)
Yonsei Authors
김송이(Kim, Song Yee) ORCID logo https://orcid.org/0000-0001-8627-486X
김영삼(Kim, Young Sam)
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
송주한(Song, Joo Han)
이진구(Lee, Jin Gu)
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