Impact of perioperative airway pathogens on living-donor lobar lung transplantation outcomes.
Airway pathogens
Living-donor lobar lung transplantation
Postoperative outcomes
Journal
Surgery today
ISSN: 1436-2813
Titre abrégé: Surg Today
Pays: Japan
ID NLM: 9204360
Informations de publication
Date de publication:
04 Aug 2023
04 Aug 2023
Historique:
received:
14
04
2023
accepted:
27
06
2023
medline:
4
8
2023
pubmed:
4
8
2023
entrez:
4
8
2023
Statut:
aheadofprint
Résumé
To elucidate the clinical impact of pathogenic organism (PO) positivity early after transplantation, we evaluated the impact of perioperative airway POs on outcomes after living-donor lobar lung transplantation (LDLLT), where the graft airway is supposed to be sterile from a healthy donor. A retrospective review of 67 adult LDLLT procedures involving 132 living donors was performed. Presence of POs in the recipients' airways was evaluated preoperatively and postoperatively in intensive-care units. POs were detected preoperatively in 13 (19.4%) recipients. No POs were isolated from the donor airways at transplantation. POs were detected in 39 (58.2%) recipients postoperatively; most were different from the POs isolated preoperatively. Postoperative PO isolation was not associated with short-term outcomes other than prolonged postoperative ventilation. The 5-year overall survival was significantly better in the PO-negative group than in the PO-positive group (89.1% vs. 63.7%, P = 0.014). In the multivariate analysis, advanced age (hazard ratio [HR]: 1.041 per 1-year increase, P = 0.033) and posttransplant PO positivity in the airway (HR: 3.684, P = 0.019) significantly affected the survival. The airways of the living-donor grafts were microbiologically sterile. PO positivity in the airway early after transplantation negatively impacted long-term outcomes.
Identifiants
pubmed: 37540232
doi: 10.1007/s00595-023-02730-9
pii: 10.1007/s00595-023-02730-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Japan Society for the Promotion of Science KAKENHI
ID : 20H03769
Informations de copyright
© 2023. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.
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