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

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dc.contributor.author Nykänen, Antti
dc.contributor.author Raivio, Peter
dc.contributor.author Peräkylä, Laura
dc.contributor.author Stark, Christoffer
dc.contributor.author Huuskonen, Antti
dc.contributor.author Lemström, Karl
dc.contributor.author Halme, Maija
dc.contributor.author Hämmäinen, Pekka
dc.date.accessioned 2021-03-08T22:55:10Z
dc.date.available 2021-12-18T03:45:56Z
dc.date.issued 2020-05-03
dc.identifier.citation 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
dc.identifier.other PURE: 134287277
dc.identifier.other PURE UUID: 16d2747e-1f5b-4a3f-96f6-5d1056544662
dc.identifier.other WOS: 000519171200001
dc.identifier.other ORCID: /0000-0001-6920-4093/work/76333289
dc.identifier.uri http://hdl.handle.net/10138/327662
dc.description.abstract 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. en
dc.format.extent 8
dc.language.iso eng
dc.relation.ispartof Scandinavian Cardiovascular Journal
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Lung transplantation
dc.subject end-stage pulmonary disease
dc.subject chronic lung allograft dysfunction
dc.subject chronic rejection
dc.subject bronchiolitis obliterans syndrome
dc.subject SURVIVAL
dc.subject 3121 General medicine, internal medicine and other clinical medicine
dc.subject 3126 Surgery, anesthesiology, intensive care, radiology
dc.title Incidence and impact of chronic lung allograft dysfunction after lung transplantation - single-center 14-year experience en
dc.type Article
dc.contributor.organization Staff Services
dc.contributor.organization Transplantation Laboratory
dc.contributor.organization HUS Heart and Lung Center
dc.contributor.organization III kirurgian klinikka
dc.contributor.organization University of Helsinki
dc.contributor.organization Department of Surgery
dc.contributor.organization Sydän ja rintaelinkirurgia
dc.contributor.organization Helsinki University Hospital Area
dc.contributor.organization Clinicum
dc.contributor.organization HUSLAB
dc.contributor.organization Keuhkosairauksien yksikkö
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1080/14017431.2020.1726444
dc.relation.issn 1401-7431
dc.rights.accesslevel openAccess
dc.type.version acceptedVersion

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