TY - JOUR
T1 - Characteristics and outcomes among patients with need for early dialysis after lung transplantation surgery
AU - Banga, Amit
AU - Mohanka, Manish
AU - Mullins, Jessica
AU - Bollineni, Srinivas
AU - Kaza, Vaidehi
AU - Tanriover, Bekir
AU - Torres, Fernando
N1 - Publisher Copyright:
© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
PY - 2017/11
Y1 - 2017/11
N2 - Background: With the introduction of lung allocation score (LAS), increasingly sicker patients are undergoing lung transplantation (LT). This study was conducted to determine the time trends in need for dialysis after LT, identify variables independently associated with need for dialysis, and evaluate its association with 1- and 5-year mortality. Methods: We queried the United Network of Organ Sharing database for adult patients undergoing LT between 1994 and 2014. We excluded patients with simultaneous dual organ transplantation and where data regarding the need for dialysis were not available. Results: Time trends in the yearly incidence of the need for dialysis showed a gradual increase (P =.012). In the post-LAS era, ethnicity, underlying diagnosis, estimated GFR <90 mL/min/1.73 m2 and mean pulmonary pressures>35 mm Hg, ventilator or extracorporeal membrane oxygenation support at LT, and >20% increase in serum creatinine between listing and match were independently associated with the need for dialysis. Patients with need for dialysis had significantly increased hazard of 1-year (n = 13 849; adjusted hazard ratio, 95% CI:7.23, 6.2-8.4, P <.001) and 5-year mortality (n = 7287; adjusted hazard ratio, 95% CI:3.96, 3.43-4.56, P <.001). Conclusions: There is a gradual increase in the incidence of the need for early dialysis after LT, and these patients have significantly worse early and late survival. Several pre-transplant recipient characteristics are independently associated with the need for dialysis.
AB - Background: With the introduction of lung allocation score (LAS), increasingly sicker patients are undergoing lung transplantation (LT). This study was conducted to determine the time trends in need for dialysis after LT, identify variables independently associated with need for dialysis, and evaluate its association with 1- and 5-year mortality. Methods: We queried the United Network of Organ Sharing database for adult patients undergoing LT between 1994 and 2014. We excluded patients with simultaneous dual organ transplantation and where data regarding the need for dialysis were not available. Results: Time trends in the yearly incidence of the need for dialysis showed a gradual increase (P =.012). In the post-LAS era, ethnicity, underlying diagnosis, estimated GFR <90 mL/min/1.73 m2 and mean pulmonary pressures>35 mm Hg, ventilator or extracorporeal membrane oxygenation support at LT, and >20% increase in serum creatinine between listing and match were independently associated with the need for dialysis. Patients with need for dialysis had significantly increased hazard of 1-year (n = 13 849; adjusted hazard ratio, 95% CI:7.23, 6.2-8.4, P <.001) and 5-year mortality (n = 7287; adjusted hazard ratio, 95% CI:3.96, 3.43-4.56, P <.001). Conclusions: There is a gradual increase in the incidence of the need for early dialysis after LT, and these patients have significantly worse early and late survival. Several pre-transplant recipient characteristics are independently associated with the need for dialysis.
KW - 1-year survival
KW - 5-year survival
KW - chronic kidney disease
KW - lung allocation score
KW - recipient characteristics
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U2 - 10.1111/ctr.13106
DO - 10.1111/ctr.13106
M3 - Article
C2 - 28871631
AN - SCOPUS:85031682674
SN - 0902-0063
VL - 31
JO - Clinical Transplantation
JF - Clinical Transplantation
IS - 11
M1 - e13106
ER -