Impact of time interval between donor brain death and cold preservation on long-term outcome in lung transplantation.
- Pecoraro Y Department of Thoracic Surgery, Zurich University Hospital, Zurich, Switzerland.
- Tsushima Y Department of Thoracic Surgery, Zurich University Hospital, Zurich, Switzerland.
- Opitz I Department of Thoracic Surgery, Zurich University Hospital, Zurich, Switzerland.
- Benden C Division of Pulmonary Medicine, Zurich University Hospital, Zurich, Switzerland.
- Schüpbach R Division of Surgical Intensive Care, Zurich University Hospital, Zurich, Switzerland.
- Lenherr R Division of Surgical Intensive Care, Zurich University Hospital, Zurich, Switzerland.
- Jungraithmayr W Department of Thoracic Surgery, Zurich University Hospital, Zurich, Switzerland.
- Weder W Department of Thoracic Surgery, Zurich University Hospital, Zurich, Switzerland.
- Inci I Department of Thoracic Surgery, Zurich University Hospital, Zurich, Switzerland ilhan.inci@usz.ch.
- 2016-02-20
Published in:
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. - 2016
Brain death
Cold ischaemic time
Cold preservation
Lung transplantation
Outcome
Survival
Adolescent
Adult
Aged
Brain Death
Cryopreservation
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Lung Transplantation
Male
Middle Aged
Respiratory Insufficiency
Retrospective Studies
Risk Factors
Survival Rate
Switzerland
Time Factors
Time-to-Treatment
Tissue Donors
Young Adult
English
OBJECTIVES
Brain death (BD) is associated with various systemic responses and a cascade of inflammatory reactions. It is still unknown how the time interval from BD to cold preservation (CP) affects outcome after lung transplantation (LTx). This report investigates the impact of the time interval from BD to CP on long-term outcome in LTx.
METHODS
We reviewed 250 consecutive recipients who underwent LTx at our institution between January 2000 and December 2011. In Group I (n = 212), the time interval from BD to CP was <24 h, and in Group II (n = 38) >24 h. Cox proportional hazard regression analysis was performed to determine the risk factors affecting survival.
RESULTS
The median time from BD to CP was 18.6 h (range 9-65). The rate of postoperative complications was comparable (P = 0.8). The 30-day mortality rate was 7.5% in Group I and 0% in Group II. The 5-year survival rate was better in Group II [70% (95% CI: 48.5-83.8%)] than in Group I [66% (95% CI: 58.3-72.5%)] without statistical significance (P = 0.3). Intraoperative extracorporeal membrane oxygenation (ECMO) use was identified as a significant risk factor for survival [HR = 1.7, (95% CI: 1.1-2.6), P = 0.01].
CONCLUSION
In our cohort, the time interval from BD to CP had no impact on long-term outcome after LTx.
Brain death (BD) is associated with various systemic responses and a cascade of inflammatory reactions. It is still unknown how the time interval from BD to cold preservation (CP) affects outcome after lung transplantation (LTx). This report investigates the impact of the time interval from BD to CP on long-term outcome in LTx.
METHODS
We reviewed 250 consecutive recipients who underwent LTx at our institution between January 2000 and December 2011. In Group I (n = 212), the time interval from BD to CP was <24 h, and in Group II (n = 38) >24 h. Cox proportional hazard regression analysis was performed to determine the risk factors affecting survival.
RESULTS
The median time from BD to CP was 18.6 h (range 9-65). The rate of postoperative complications was comparable (P = 0.8). The 30-day mortality rate was 7.5% in Group I and 0% in Group II. The 5-year survival rate was better in Group II [70% (95% CI: 48.5-83.8%)] than in Group I [66% (95% CI: 58.3-72.5%)] without statistical significance (P = 0.3). Intraoperative extracorporeal membrane oxygenation (ECMO) use was identified as a significant risk factor for survival [HR = 1.7, (95% CI: 1.1-2.6), P = 0.01].
CONCLUSION
In our cohort, the time interval from BD to CP had no impact on long-term outcome after LTx.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1093/ejcts/ezw028
- PMID 26893381
- Persistent URL
- https://sonar.ch/global/documents/236433
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