Primary graft dysfunction and other selected complications of lung transplantation: A single-center experience of 983 patients

Bryan F. Meyers, Maite De La Morena, Stuart C. Sweet, Elbert P. Trulock, Tracey J. Guthrie, Eric N. Mendeloff, Charles Huddleston, Joel D. Cooper, G. Alexander Patterson

Research output: Contribution to journalArticle

94 Citations (Scopus)

Abstract

Objectives: We sought to review the incidence and outcome of lung transplantation complications observed over 15 years at a single center. Methods: We performed a retrospective review from our databases, tracking outcomes after adult and pediatric lung transplantation. The 983 operations between July 1988 and September 2003 included 277 pediatric and 706 adult recipients. Bilateral (74%), unilateral (19%), and living lobar transplants (4%) comprised the bulk of this experience. Retransplantations accounted for 44 (4.5%) of the operations. Results: The groups differed by indication for transplantation. The adults included 57% with emphysema and 17% with cystic fibrosis, and the children included no patients with emphysema and 50% with cystic fibrosis. Hospital mortality was 96 (9.8%) of 983, including 46 (17%) of 277 of the children and 50 (7%) of 706 of the adults. The overall survival curves did not differ between adults and children (P =. 56). Freedom from bronchiolitis obliterans syndrome at 5 and 10 years was 45% and 18% for adults and 48% and 30% for children, respectively (P = .53). The causes of death for adults included bronchiolitis obliterans syndrome (40%), respiratory failure (17%), and infection (14%), whereas the causes of death in children included bronchiolitis obliterans syndrome (35%), infection (28%), and respiratory failure (21%) (P < .01). Posttransplantation lymphoproliferative disease occurred in 12% of pediatric recipients and 6% of adults (P < .01). The frequency of treated airway complications did not differ between adults and children (9% vs 11%, P =. 48). The frequency of primary graft dysfunction did not differ between children (22%) and adults (23%), despite disparity in the use of cardiopulmonary bypass. Conclusion: These results highlight major complications after lung transplantation. Despite differences in underlying diagnoses and operative techniques, the 2 cohorts of patients experienced remarkably similar outcomes.

Original languageEnglish (US)
JournalJournal of Thoracic and Cardiovascular Surgery
Volume129
Issue number6
DOIs
StatePublished - Jun 2005

Fingerprint

Primary Graft Dysfunction
Lung Transplantation
Bronchiolitis Obliterans
Emphysema
Pediatrics
Cystic Fibrosis
Respiratory Insufficiency
Cause of Death
Hospital Mortality
Cardiopulmonary Bypass
Respiratory Tract Infections
Transplantation
Databases
Transplants
Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Primary graft dysfunction and other selected complications of lung transplantation : A single-center experience of 983 patients. / Meyers, Bryan F.; De La Morena, Maite; Sweet, Stuart C.; Trulock, Elbert P.; Guthrie, Tracey J.; Mendeloff, Eric N.; Huddleston, Charles; Cooper, Joel D.; Patterson, G. Alexander.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 129, No. 6, 06.2005.

Research output: Contribution to journalArticle

Meyers, BF, De La Morena, M, Sweet, SC, Trulock, EP, Guthrie, TJ, Mendeloff, EN, Huddleston, C, Cooper, JD & Patterson, GA 2005, 'Primary graft dysfunction and other selected complications of lung transplantation: A single-center experience of 983 patients', Journal of Thoracic and Cardiovascular Surgery, vol. 129, no. 6. https://doi.org/10.1016/j.jtcvs.2005.01.022
Meyers, Bryan F. ; De La Morena, Maite ; Sweet, Stuart C. ; Trulock, Elbert P. ; Guthrie, Tracey J. ; Mendeloff, Eric N. ; Huddleston, Charles ; Cooper, Joel D. ; Patterson, G. Alexander. / Primary graft dysfunction and other selected complications of lung transplantation : A single-center experience of 983 patients. In: Journal of Thoracic and Cardiovascular Surgery. 2005 ; Vol. 129, No. 6.
@article{e3d874d5e87b4caea0a60419151d2e59,
title = "Primary graft dysfunction and other selected complications of lung transplantation: A single-center experience of 983 patients",
abstract = "Objectives: We sought to review the incidence and outcome of lung transplantation complications observed over 15 years at a single center. Methods: We performed a retrospective review from our databases, tracking outcomes after adult and pediatric lung transplantation. The 983 operations between July 1988 and September 2003 included 277 pediatric and 706 adult recipients. Bilateral (74{\%}), unilateral (19{\%}), and living lobar transplants (4{\%}) comprised the bulk of this experience. Retransplantations accounted for 44 (4.5{\%}) of the operations. Results: The groups differed by indication for transplantation. The adults included 57{\%} with emphysema and 17{\%} with cystic fibrosis, and the children included no patients with emphysema and 50{\%} with cystic fibrosis. Hospital mortality was 96 (9.8{\%}) of 983, including 46 (17{\%}) of 277 of the children and 50 (7{\%}) of 706 of the adults. The overall survival curves did not differ between adults and children (P =. 56). Freedom from bronchiolitis obliterans syndrome at 5 and 10 years was 45{\%} and 18{\%} for adults and 48{\%} and 30{\%} for children, respectively (P = .53). The causes of death for adults included bronchiolitis obliterans syndrome (40{\%}), respiratory failure (17{\%}), and infection (14{\%}), whereas the causes of death in children included bronchiolitis obliterans syndrome (35{\%}), infection (28{\%}), and respiratory failure (21{\%}) (P < .01). Posttransplantation lymphoproliferative disease occurred in 12{\%} of pediatric recipients and 6{\%} of adults (P < .01). The frequency of treated airway complications did not differ between adults and children (9{\%} vs 11{\%}, P =. 48). The frequency of primary graft dysfunction did not differ between children (22{\%}) and adults (23{\%}), despite disparity in the use of cardiopulmonary bypass. Conclusion: These results highlight major complications after lung transplantation. Despite differences in underlying diagnoses and operative techniques, the 2 cohorts of patients experienced remarkably similar outcomes.",
author = "Meyers, {Bryan F.} and {De La Morena}, Maite and Sweet, {Stuart C.} and Trulock, {Elbert P.} and Guthrie, {Tracey J.} and Mendeloff, {Eric N.} and Charles Huddleston and Cooper, {Joel D.} and Patterson, {G. Alexander}",
year = "2005",
month = "6",
doi = "10.1016/j.jtcvs.2005.01.022",
language = "English (US)",
volume = "129",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - Primary graft dysfunction and other selected complications of lung transplantation

T2 - A single-center experience of 983 patients

AU - Meyers, Bryan F.

AU - De La Morena, Maite

AU - Sweet, Stuart C.

AU - Trulock, Elbert P.

AU - Guthrie, Tracey J.

AU - Mendeloff, Eric N.

AU - Huddleston, Charles

AU - Cooper, Joel D.

AU - Patterson, G. Alexander

PY - 2005/6

Y1 - 2005/6

N2 - Objectives: We sought to review the incidence and outcome of lung transplantation complications observed over 15 years at a single center. Methods: We performed a retrospective review from our databases, tracking outcomes after adult and pediatric lung transplantation. The 983 operations between July 1988 and September 2003 included 277 pediatric and 706 adult recipients. Bilateral (74%), unilateral (19%), and living lobar transplants (4%) comprised the bulk of this experience. Retransplantations accounted for 44 (4.5%) of the operations. Results: The groups differed by indication for transplantation. The adults included 57% with emphysema and 17% with cystic fibrosis, and the children included no patients with emphysema and 50% with cystic fibrosis. Hospital mortality was 96 (9.8%) of 983, including 46 (17%) of 277 of the children and 50 (7%) of 706 of the adults. The overall survival curves did not differ between adults and children (P =. 56). Freedom from bronchiolitis obliterans syndrome at 5 and 10 years was 45% and 18% for adults and 48% and 30% for children, respectively (P = .53). The causes of death for adults included bronchiolitis obliterans syndrome (40%), respiratory failure (17%), and infection (14%), whereas the causes of death in children included bronchiolitis obliterans syndrome (35%), infection (28%), and respiratory failure (21%) (P < .01). Posttransplantation lymphoproliferative disease occurred in 12% of pediatric recipients and 6% of adults (P < .01). The frequency of treated airway complications did not differ between adults and children (9% vs 11%, P =. 48). The frequency of primary graft dysfunction did not differ between children (22%) and adults (23%), despite disparity in the use of cardiopulmonary bypass. Conclusion: These results highlight major complications after lung transplantation. Despite differences in underlying diagnoses and operative techniques, the 2 cohorts of patients experienced remarkably similar outcomes.

AB - Objectives: We sought to review the incidence and outcome of lung transplantation complications observed over 15 years at a single center. Methods: We performed a retrospective review from our databases, tracking outcomes after adult and pediatric lung transplantation. The 983 operations between July 1988 and September 2003 included 277 pediatric and 706 adult recipients. Bilateral (74%), unilateral (19%), and living lobar transplants (4%) comprised the bulk of this experience. Retransplantations accounted for 44 (4.5%) of the operations. Results: The groups differed by indication for transplantation. The adults included 57% with emphysema and 17% with cystic fibrosis, and the children included no patients with emphysema and 50% with cystic fibrosis. Hospital mortality was 96 (9.8%) of 983, including 46 (17%) of 277 of the children and 50 (7%) of 706 of the adults. The overall survival curves did not differ between adults and children (P =. 56). Freedom from bronchiolitis obliterans syndrome at 5 and 10 years was 45% and 18% for adults and 48% and 30% for children, respectively (P = .53). The causes of death for adults included bronchiolitis obliterans syndrome (40%), respiratory failure (17%), and infection (14%), whereas the causes of death in children included bronchiolitis obliterans syndrome (35%), infection (28%), and respiratory failure (21%) (P < .01). Posttransplantation lymphoproliferative disease occurred in 12% of pediatric recipients and 6% of adults (P < .01). The frequency of treated airway complications did not differ between adults and children (9% vs 11%, P =. 48). The frequency of primary graft dysfunction did not differ between children (22%) and adults (23%), despite disparity in the use of cardiopulmonary bypass. Conclusion: These results highlight major complications after lung transplantation. Despite differences in underlying diagnoses and operative techniques, the 2 cohorts of patients experienced remarkably similar outcomes.

UR - http://www.scopus.com/inward/record.url?scp=20444420862&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=20444420862&partnerID=8YFLogxK

U2 - 10.1016/j.jtcvs.2005.01.022

DO - 10.1016/j.jtcvs.2005.01.022

M3 - Article

C2 - 15942587

AN - SCOPUS:20444420862

VL - 129

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 6

ER -