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Impact of allograft ischemic time on long-term survival in lung transplantation: a Swedish monocentric study.
Scandinavian Cardiovascular Journal ( IF 1.2 ) Pub Date : 2020-06-23 , DOI: 10.1080/14017431.2020.1781240
Haider Ghaidan 1 , Mohammed Fakhro 1 , Sandra Lindstedt 1
Affiliation  

Abstract

Purpose: The influence of allograft ischemic time (IT) on short- and long-term mortality remains under debate in lung transplantation (LTx). Due to a scarcity in donors, better understanding of IT might improve the outcome after LTx. Methods: Between January 1990 and June 2016; 307 patients underwent LTx at Lund university hospital, Sweden. The end-point used was death/Re-LTx assessed by Cox regression and Kaplan–Meier survival. Results: Kaplan–Meier survival for mean IT (min) between subgroups ≤120, 121–240, 241–360 and 361+ showed significant difference for pairwise-comparisons with superior outcome for IT between ≤120 and 240 min. Cox regression analyses for each hour of IT in patients with a limited survival up to 1- and 5-year had a hazard ratio (HR) of 1.119 and 1.063 respectively (p < .05). Conclusions: In LTx, every 2-hour increase of IT is equivalent to an increased mortality of up to 24% within 5 years. LTx with an IT of ≤120 min had a superior survival in both 1- and 5 years in comparison to an IT of up to 360 min. Better application of IT provides a key role in improving LTx outcome.



中文翻译:

同种异体移植缺血时间对肺移植长期存活的影响:瑞典一项单中心研究。

摘要

目的:同种异体移植缺血时间(IT)对短期和长期死亡率的影响在肺移植(LTx)中仍存在争议。由于捐助者的短缺,更好地了解IT可能会改善LTx后的结果。方法: 1990年1月至2016年6月; 307名患者在瑞典隆德大学医院接受LTx治疗。使用的终点是通过Cox回归和Kaplan-Meier生存评估的死亡/ Re-LTx。结果:≤120、121–240、241–360和361+的亚组之间的平均IT(min)的Kaplan–Meier生存率在成对比较中显示出显着差异,IT≤120和240 min的结果更为优越。对于生存时间有限(长达1年和5年)的患者,每小时IT的Cox回归分析的危险比(HR)分别为1.119和1.063(p  <.05)。结论:在LTx中,IT的每2小时增加相当于5年内死亡率增加高达24%。IT≤120分钟的LTx在1年和5年中的生存期均优于360分钟的IT。更好地应用IT可以在改善LTx结果方面发挥关键作用。

更新日期:2020-06-23
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