Etiologies and Outcomes of Acute Respiratory Failure in Solid Organ Transplant Recipients : Insight Into the EFRAIM Multicenter Cohort

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Efraim Investigators Nine-I Study , Messika , J , Darmon , M , Mal , H , Valkonen , M & Azoulay , E 2020 , ' Etiologies and Outcomes of Acute Respiratory Failure in Solid Organ Transplant Recipients : Insight Into the EFRAIM Multicenter Cohort ' , Transplantation Proceedings , vol. 52 , no. 10 , pp. 2980-2987 . https://doi.org/10.1016/j.transproceed.2020.02.170

Title: Etiologies and Outcomes of Acute Respiratory Failure in Solid Organ Transplant Recipients : Insight Into the EFRAIM Multicenter Cohort
Author: Efraim Investigators Nine-I Study; Messika, Jonathan; Darmon, Michael; Mal, Herve; Valkonen, Miia; Azoulay, Elie
Contributor: University of Helsinki, HUS Perioperative, Intensive Care and Pain Medicine
Date: 2020-12
Language: eng
Number of pages: 8
Belongs to series: Transplantation Proceedings
ISSN: 0041-1345
URI: http://hdl.handle.net/10138/324589
Abstract: Background. Respiratory complications of solid organ transplant (SOT) are a diagnostic and therapeutic challenge when requiring intensive care unit (ICU) admission. We aimed at describing this challenge in a prospective cohort of SOT recipients admitted in the ICU. Methods. In this post hoc analysis of an international cohort of immunocompromised patients admitted in the ICU for an acute respiratory failure, we analyzed all SOT recipients and compared their severity, etiologic diagnosis, prognosis, and outcome ac-cording to the performance of an invasive diagnostic strategy (encompassing a fiber-optic bronchoscopy and bronchoalveolar lavage), the type of transplanted organ, and the need of invasive ventilation at day 1. Results. Among 1611 patients included in the primary study, 142 were SOT recipients (kidney, n = 73; 51.4%; lung, n = 33; 23.2%; liver, n = 29; 20.4%; heart, n = 7; 4.9%). Lung transplant recipients were younger than other SOT recipients, and severity did not differ across type of received organ. An invasive diagnostic strategy was more frequently performed in lung transplant recipients with a trend toward a higher rate of bacterial etiology in lung than kidney transplant recipients. Overall ICU survival of SOT recipients was 75.4%. Invasive diagnostic strategy, type of transplanted organ, and need of invasive mechanical ventilation at day 1 did not affect ICU prognosis. Conclusions. ICU management of hypoxemic acute respiratory failure in SOT recipients translated into a low ICU mortality rate, whatever the transplanted organ or the acute respiratory failure cause. The post-ICU burden of acute respiratory failure SOT recipients remains to be investigated.
Subject: IMMUNOCOMPROMISED PATIENTS
PULMONARY COMPLICATIONS
NONINVASIVE VENTILATION
ONCOLOGY PATIENTS
THERAPY
BRONCHOSCOPY
INTUBATION
HEMATOLOGY
OXYGEN
3126 Surgery, anesthesiology, intensive care, radiology
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