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

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)3275-3282
Number of pages8
JournalJournal of Thoracic Disease
Volume8
Issue number11
DOIs
Publication statusPublished - 2016 Jan 1

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Primary Graft Dysfunction
Lung Transplantation
Korea
Body Mass Index
Renal Replacement Therapy
Transplantation
Mechanical Ventilators
Intensive Care Units
Odds Ratio

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

Cite this

Moon, Sungwoo ; Park, Moo Suk ; Lee, Jin Gu ; Jung, Ji Ye ; Kang, Young Ae ; Kim, Young Sam ; Kim, Se Kyu ; Chang, Joon ; Paik, Hyo Chae ; Kim, Song Yee. / Risk factors and outcome of primary graft dysfunction after lung transplantation in Korea. In: Journal of Thoracic Disease. 2016 ; Vol. 8, No. 11. pp. 3275-3282.
@article{037d5d2d0a3d436eb7c1dae3f2bd8613,
title = "Risk factors and outcome of primary graft dysfunction after lung transplantation in Korea",
abstract = "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.",
author = "Sungwoo Moon and Park, {Moo Suk} and Lee, {Jin Gu} and Jung, {Ji Ye} and Kang, {Young Ae} and Kim, {Young Sam} and Kim, {Se Kyu} and Joon Chang and Paik, {Hyo Chae} and Kim, {Song Yee}",
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Moon, S, Park, MS, Lee, JG, Jung, JY, Kang, YA, Kim, YS, Kim, SK, Chang, J, Paik, HC & Kim, SY 2016, 'Risk factors and outcome of primary graft dysfunction after lung transplantation in Korea', Journal of Thoracic Disease, vol. 8, no. 11, pp. 3275-3282. https://doi.org/10.21037/jtd.2016.11.48

Risk factors and outcome of primary graft dysfunction after lung transplantation in Korea. / Moon, Sungwoo; Park, Moo Suk; Lee, Jin Gu; Jung, Ji Ye; Kang, Young Ae; Kim, Young Sam; Kim, Se Kyu; Chang, Joon; Paik, Hyo Chae; Kim, Song Yee.

In: Journal of Thoracic Disease, Vol. 8, No. 11, 01.01.2016, p. 3275-3282.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk factors and outcome of primary graft dysfunction after lung transplantation in Korea

AU - Moon, Sungwoo

AU - Park, Moo Suk

AU - Lee, Jin Gu

AU - Jung, Ji Ye

AU - Kang, Young Ae

AU - Kim, Young Sam

AU - Kim, Se Kyu

AU - Chang, Joon

AU - Paik, Hyo Chae

AU - Kim, Song Yee

PY - 2016/1/1

Y1 - 2016/1/1

N2 - 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.

AB - 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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