دورية أكاديمية
Risk Factors, Incidence, and Outcomes Associated With Clinically Significant Airway Ischemia.
| العنوان: | Risk Factors, Incidence, and Outcomes Associated With Clinically Significant Airway Ischemia. |
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| المؤلفون: | Li G; Department of Medicine, Baylor College of Medicine, Houston, TX, United States., Liu Z; Department of Statistics, Rice University, Houston, TX, United States., Salan-Gomez M; Department of Surgery, Baylor College of Medicine, Houston, TX, United States., Keeney E; Department of Surgery, Baylor College of Medicine, Houston, TX, United States., D'Silva E; Department of Surgery, Baylor College of Medicine, Houston, TX, United States., Mankidy B; Department of Medicine, Baylor College of Medicine, Houston, TX, United States., Leon A; Department of Surgery, Baylor College of Medicine, Houston, TX, United States., Mattar A; Department of Surgery, Baylor College of Medicine, Houston, TX, United States., Elsennousi A; Department of Surgery, Baylor College of Medicine, Houston, TX, United States., Coster J; Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States., Kumar A; Department of Medicine, University of Minnesota, Minneapolis, MN, United States., Rodrigues B; Department of Medicine, Baylor College of Medicine, Houston, TX, United States., Li M; Department of Statistics, Rice University, Houston, TX, United States., Shafii A; Department of Surgery, Baylor College of Medicine, Houston, TX, United States., Garcha P; Department of Medicine, Baylor College of Medicine, Houston, TX, United States., Loor G; Department of Surgery, Baylor College of Medicine, Houston, TX, United States. |
| المصدر: | Transplant international : official journal of the European Society for Organ Transplantation [Transpl Int] 2024 May 10; Vol. 37, pp. 12751. Date of Electronic Publication: 2024 May 10 (Print Publication: 2024). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Frontiers Media S. A Country of Publication: Switzerland NLM ID: 8908516 Publication Model: eCollection Cited Medium: Internet ISSN: 1432-2277 (Electronic) Linking ISSN: 09340874 NLM ISO Abbreviation: Transpl Int Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2022- : Lausanne, Switzerland : Frontiers Media S. A. Original Publication: [Heidelberg, FRG] : Springer International, 1988- |
| مواضيع طبية MeSH: | Lung Transplantation*/adverse effects , Ischemia*/etiology, Humans ; Male ; Risk Factors ; Middle Aged ; Female ; Retrospective Studies ; Incidence ; Adult ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Aged ; Lung/blood supply |
| مستخلص: | Airway complications following lung transplantation remain an important cause of morbidity and mortality. We aimed to identify the incidence, risk factors and outcomes associated with clinically significant airway ischemia (CSAI) in our center. We reviewed 217 lung transplants (386 airway anastomoses) performed at our institution between February 2016 and December 2020. Airway images were graded using the 2018 ISHLT grading guidelines modified slightly for retrospective analysis. Airways were considered to have CSAI if they developed ischemia severity >B2, stenosis >50%, and/or any degree of dehiscence within 6-months of transplant. Regression analyses were used to evaluate outcomes and risk factors for CSAI. Eighty-two patients (37.8%) met criteria for CSAI. Of these, twenty-six (32%) developed stenosis and/or dehiscence, and 17 (21%) required interventions. Patients with CSAI had lower one-year (80.5% vs. 91.9%, p = 0.05) and three-year (67.1% vs. 77.8%, p = 0.08) survival than patients without CSAI. Factors associated with CSAI included younger recipient age, recipient diabetes, single running suture technique, performance of the left anastomosis first, lower venous oxygen saturation within 48-h, and takeback for major bleeding. Our single-center analysis suggests that airway ischemia remains a major obstacle in contemporary lung transplantation. Improving the local healing milieu of the airway anastomosis could potentially mitigate this risk. Competing Interests: GaL, MD is a consultant for Transmedics, Inc. and Abiomed Breathe. GaL receives institutional grant support to Baylor College of Medicine from the American Association of Thoracic Surgeons, the Roderick McDonald Foundation, and Abbot. He is a recipient of the George P. Noon Endowment from Baylor College of Medicine Michael E. DeBakey Foundation. GaL’s institution Baylor College of Medicine receives grant support from the JLH foundation, Transmedics, Abiomed, Atricure, and Getinge. PG is a consultant for United Therapeutics. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Li, Liu, Salan-Gomez, Keeney, D’Silva, Mankidy, Leon, Mattar, Elsennousi, Coster, Kumar, Rodrigues, Li, Shafii, Garcha and Loor.) |
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| فهرسة مساهمة: | Keywords: airway anastomosis; airway dehiscence; airway ischemia; airway stenosis; lung transplant |
| تواريخ الأحداث: | Date Created: 20240527 Date Completed: 20240527 Latest Revision: 20240528 |
| رمز التحديث: | 20240528 |
| مُعرف محوري في PubMed: | PMC11119282 |
| DOI: | 10.3389/ti.2024.12751 |
| PMID: | 38800671 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1432-2277 |
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| DOI: | 10.3389/ti.2024.12751 |