Incidence and impact of chronic lung allograft dysfunction after lung transplantation - single-center 14-year experience

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http://hdl.handle.net/10138/327662

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Nykänen , A , Raivio , P , Peräkylä , L , Stark , C , Huuskonen , A , Lemström , K , Halme , M & Hämmäinen , P 2020 , ' Incidence and impact of chronic lung allograft dysfunction after lung transplantation - single-center 14-year experience ' , Scandinavian Cardiovascular Journal , vol. 54 , no. 3 , pp. 192-199 . https://doi.org/10.1080/14017431.2020.1726444

Titel: Incidence and impact of chronic lung allograft dysfunction after lung transplantation - single-center 14-year experience
Författare: Nykänen, Antti; Raivio, Peter; Peräkylä, Laura; Stark, Christoffer; Huuskonen, Antti; Lemström, Karl; Halme, Maija; Hämmäinen, Pekka
Upphovmannens organisation: Staff Services
Transplantation Laboratory
HUS Heart and Lung Center
III kirurgian klinikka
University of Helsinki
Department of Surgery
Sydän ja rintaelinkirurgia
Helsinki University Hospital Area
Clinicum
HUSLAB
Keuhkosairauksien yksikkö
Datum: 2020-05-03
Språk: eng
Sidantal: 8
Tillhör serie: Scandinavian Cardiovascular Journal
ISSN: 1401-7431
DOI: https://doi.org/10.1080/14017431.2020.1726444
Permanenta länken (URI): http://hdl.handle.net/10138/327662
Abstrakt: Objectives. Lung transplantation remains the only available treatment option for many end-stage lung diseases. We evaluated our long-term lung transplantation results and the impact of chronic lung allograft dysfunction (CLAD). Design. Adult de novo lung transplants (2003-2015, n=175) in a nationwide single transplant center were retrospectively analyzed. Kaplan-Meier survival and Cox regression analysis were used to evaluate the effect of CLAD. Results. Recipient and graft 1-, 5- and 10-year survival estimates were 94%, 79% and 64%, and 93%, 75% and 59%, respectively. CLAD affected 43% of patients at a median of 2.3 years after transplantation, and impaired recipient (p = .03) and graft survival (p = .001) with the most advanced CLAD stage, and restrictive CLAD phenotype, resulting in worst graft survival. CLAD was the primary cause of death in 54% of all patients, and in 80% of patients with an established CLAD diagnosis. CLAD, high-risk cytomegalovirus serostatus, and recipient preoperative sensitization increased graft loss hazard ratio. CLAD was the only significant investigated risk factor for graft loss in multivariate regression analysis. Conclusions. Although very favourable lung transplant patient long-term survival was achieved, CLAD significantly impaired recipient and graft survival. Identification of risk factors and therapeutic options for CLAD may further improve lung transplantation results.
Subject: Lung transplantation
end-stage pulmonary disease
chronic lung allograft dysfunction
chronic rejection
bronchiolitis obliterans syndrome
SURVIVAL
3121 General medicine, internal medicine and other clinical medicine
3126 Surgery, anesthesiology, intensive care, radiology
Referentgranskad: Ja
Användningsbegränsning: openAccess
Parallelpublicerad version: acceptedVersion


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