Blood transfusion of the donor is associated with stage 3 primary graft dysfunction after lung transplantation.
blood transfusion
donor
lung transplantation
primary graft dysfunction
Journal
Clinical transplantation
ISSN: 1399-0012
Titre abrégé: Clin Transplant
Pays: Denmark
ID NLM: 8710240
Informations de publication
Date de publication:
09 2021
09 2021
Historique:
revised:
21
06
2021
received:
24
03
2021
accepted:
23
06
2021
pubmed:
27
6
2021
medline:
11
11
2021
entrez:
26
6
2021
Statut:
ppublish
Résumé
The first aim of this study was to assess the association between stage 3 PGD and pre-donation blood transfusion of the donor. The secondary objectives were to assess the epidemiology of donor transfusion and the outcome of LT recipients according to donor transfusion status and massive donor transfusion status. This was an observational, prospective, single-center study. The results are expressed as absolute numbers, percentages, medians, and interquartile ranges. Statistical analyses were performed using Chi squared, Fischer's exact tests, and Mann-Whitney U tests (P < .05 was considered significant). A multivariate analysis was performed. Between January 2016 and February 2019, 147 patients were included in the analysis. PGD was observed in 79 (54%) patients, 45 (31%) of whom had stage 3 PGD. Pre-donation blood transfusion was administered in 48 (33%) donors (median of 3[1-9] packed red cells (PRCs)). On multivariate analysis, stage 3 PGD was significantly associated with donor blood transfusion (OR 2.69, IC (1.14-6.38), P = .024). Mortality at days 28 and 90 was not significantly different according to the pre-donation transfusion status of the donor. Pre-donation blood transfusion is associated with stage 3 PGD occurrence after LT. Transfusion data of the donor should be included in donor lung assessment.
Sections du résumé
BACKGROUND
The first aim of this study was to assess the association between stage 3 PGD and pre-donation blood transfusion of the donor. The secondary objectives were to assess the epidemiology of donor transfusion and the outcome of LT recipients according to donor transfusion status and massive donor transfusion status.
METHODS
This was an observational, prospective, single-center study. The results are expressed as absolute numbers, percentages, medians, and interquartile ranges. Statistical analyses were performed using Chi squared, Fischer's exact tests, and Mann-Whitney U tests (P < .05 was considered significant). A multivariate analysis was performed.
RESULTS
Between January 2016 and February 2019, 147 patients were included in the analysis. PGD was observed in 79 (54%) patients, 45 (31%) of whom had stage 3 PGD. Pre-donation blood transfusion was administered in 48 (33%) donors (median of 3[1-9] packed red cells (PRCs)). On multivariate analysis, stage 3 PGD was significantly associated with donor blood transfusion (OR 2.69, IC (1.14-6.38), P = .024). Mortality at days 28 and 90 was not significantly different according to the pre-donation transfusion status of the donor.
CONCLUSION
Pre-donation blood transfusion is associated with stage 3 PGD occurrence after LT. Transfusion data of the donor should be included in donor lung assessment.
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14407Informations de copyright
© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Références
Suzuki Y, Cantu E, Christie JD. Primary graft dysfunction. Semin Respir Crit Care Med. 2013;34(3):305-319.
Lee JC, Christie JD. Primary graft dysfunction. Clin Chest Med. 2011;32(2):279-293.
Lee JC, Christie JD. Primary graft dysfunction. Proc Am Thorac Soc. 2009;6(1):39-46.
Thabut G, Vinatier I, Stern J-B, et al. Primary graft failure following lung transplantation. Chest. 2002;121(6):1876-1882.
Christie JD, Van Raemdonck D, de Perrot M, et al. Report of the ISHLT working group on primary lung graft dysfunction part i: introduction and methods. J Heart Lung Transplant. 2005;24(10):1451-1453.
Gelman AE, Fisher AJ, Huang HJ, et al. Report of the ISHLT Working Group on Primary Lung Graft Dysfunction Part III: mechanisms: a 2016 consensus group statement of the international society for heart and lung transplantation. J Heart Lung Transplant. 2017;36(10):1114-1120.
Snell GI, Yusen RD, Weill D, et al. Report of the ishlt working group on primary lung graft dysfunction, part I: definition and grading-a 2016 consensus group statement of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2017;36(10):1097-1103.
Rubenfeld GD, Caldwell E, Peabody E, et al. Incidence and outcomes of acute lung injury. N Engl J Med. 2005;353(16):1685-1693.
Acute Respiratory Distress Syndrome: the Berlin Definition. JAMA. 2012;307(23) [Internet]. [cited 2020 Jan 5]. Available from: https://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2012.5669
Arcasoy SM, Fisher A, Hachem RR, Scavuzzo M, Ware LB. Report of the ISHLT working group on primary lung graft dysfunction part V: predictors and outcomes. J Heart Lung Transplant. 2005;24(10):1483-1488.
de Perrot M, Bonser RS, Dark J, et al. Report of the ISHLT working group on primary lung graft dysfunction part III: donor-related risk factors and markers. J Heart Lung Transplant. 2005;24(10):1460-1467.
Christie JD, Kotloff RM, Pochettino A, et al. Clinical risk factors for primary graft failure following lung transplantation. Chest. 2003;124(4):1232-1241.
Diamond JM, Lee JC, Kawut SM, et al. Clinical risk factors for primary graft dysfunction after lung transplantation. Am J Respir Crit Care Med. 2013;187(5):527-534.
Kuntz CL, Hadjiliadis D, Ahya VN, et al. Risk factors for early primary graft dysfunction after lung transplantation: a registry study. Clin Transplant. 2009;23(6):819-830.
Barr ML, Kawut SM, Whelan TP, et al. Report of the ISHLT working group on primary lung graft dysfunction part IV: recipient-related risk factors and markers. J Heart Lung Transplant. 2005;24(10):1468-1482.
Bonser RS, Taylor R, Collett D, Thomas HL, Dark JH, Neuberger J. Effect of donor smoking on survival after lung transplantation: a cohort study of a prospective registry. The Lancet. 2012;380(9843):747-755.
Borders CF, Suzuki Y, Lasky J, et al. Massive donor transfusion potentially increases recipient mortality after lung transplantation. J Thorac Cardiovasc Surg. 2017;153(5):1197-1203.e2.
Weber D, Cottini SR, Locher P, et al. Association of intraoperative transfusion of blood products with mortality in lung transplant recipients. Perioper Med. 2013;2(1):20.
Christie JD, Shah CV, Kawut SM, et al. Plasma levels of receptor for advanced glycation end products, blood transfusion, and risk of primary graft dysfunction. Am J Respir Crit Care Med. 2009;180(10):1010-1015.
Levine DJ, Glanville AR, Aboyoun C, et al. Antibody-mediated rejection of the lung: a consensus report of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2016;35(4):397-406.
Atchade E, Desmard M, Kantor E, et al. Fungal isolation in respiratory tract after lung transplantation: epidemiology, clinical consequences, and associated factors. Transplant Proc. 2020;52(1):326-332.
Atchade E, Barour S, Tran-Dinh A, et al. Acute kidney injury after lung transplantation: perioperative risk factors and outcome. Transplant Proc. 2020;52(3):967-976.
Tanaka S, Geneve C, Tebano G, et al. Morbidity and mortality related to pneumonia and TRACHEOBRONCHITIS in ICU after lung transplantation. BMC Pulm Med. 2018;18(1):43.
Tebano G, Geneve C, Tanaka S, et al. Epidemiology and risk factors of multidrug-resistant bacteria in respiratory samples after lung transplantation. Transpl Infect Dis. 2016;18(1):22-30.
Thabut G. Survival after bilateral versus single-lung transplantation for idiopathic pulmonary fibrosis. Ann Intern Med. 2009;151(11):767.
Weber D, Cottini SR, Locher P, et al. Association of intraoperative transfusion of blood products with mortality in lung transplant recipients. Perioper Med Lond Engl. 2013;2(1):20.