[Mortality analysis of patients undergoing lung transplantation for emphysema]

Arch Bronconeumol. 2009 Jul;45(7):335-40. doi: 10.1016/j.arbres.2009.01.011. Epub 2009 May 20.
[Article in Spanish]

Abstract

Background: The outcomes of lung transplantation 11 years after starting the transplantation program in our hospital are presented. Risk factors associated with short-, medium-, and long-term mortality in transplant recipients were analyzed.

Patients and methods: All patients diagnosed with emphysema who underwent lung transplantation between March 1997 and June 2008 were included. The association between different study variables and early death and death at 1 year and 5 years was studied. The Kaplan-Meier method was used to analyze survival. A logistic regression model was used to study the association between early death and variables with a trend towards significance (P<.2) in the univariate analysis. The risk factors for mortality at 1 year and 5 years were analyzed by a Cox regression model.

Results: A total of 92 patients were included. Survival was 89.3%, 70%, and 54% at 1 month, 1 year, and 5 years after transplantation, respectively. Dehiscence of the surgical suture (P<.001), duration of mechanical ventilation in the intensive care unit (P=.04), duration of the surgical procedure (P<.001), and single-lung transplantation (P=.007) were the variables associated with mortality. Extracorporeal circulation and the need for hemodiafiltration in the intensive care unit increased the short-term risk of death (P<.05). The age of the recipient was the variable associated with long-term mortality (P=.02). The duration of the surgical intervention was associated with an increase in short-, medium-, and long-term mortality.

Conclusions: Complications were responsible for short-term mortality, while age of the recipient was the most important factor in determining long-term survival. Mortality was higher in single-lung transplant recipients compared to double-lung transplant recipients.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Cause of Death
  • Cohort Studies
  • Emphysema / etiology
  • Emphysema / surgery*
  • Female
  • Follow-Up Studies
  • Hemodiafiltration / statistics & numerical data
  • Humans
  • Kaplan-Meier Estimate
  • Logistic Models
  • Lung Transplantation / mortality*
  • Lung Transplantation / statistics & numerical data
  • Male
  • Malnutrition / epidemiology
  • Middle Aged
  • Postoperative Complications / mortality*
  • Proportional Hazards Models
  • Respiration, Artificial / statistics & numerical data
  • Sex Factors
  • Spain / epidemiology
  • Surgical Wound Dehiscence / mortality
  • Time Factors
  • Tissue Donors / statistics & numerical data
  • alpha 1-Antitrypsin Deficiency / complications