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Am J Respir Crit Care Med. 2005 Apr 1;171(7):786-91. Epub 2005 Jan 21.

Graft ischemic time and outcome of lung transplantation: a multicenter analysis.

Author information

1
Division of Pulmonary Medicine and Thoracic Surgery, Beaujon Hospital, Clichy, France. gabriel.thabut@bjn.ap-hop-paris.fr

Abstract

RATIONALE:

The effect of graft ischemic time on early graft function and long-term survival of patients who underwent lung transplantation remains controversial. Consequently, graft ischemic time has not been incorporated in the decision-making process at the time of graft acceptance.

OBJECTIVES:

To investigate the relationship between graft ischemic time and (1) early graft function and (2) long-term survival after lung transplantation.

MEASUREMENTS AND MAIN RESULTS:

The data from 752 patients who underwent single lung transplantation (n = 258), bilateral lung transplantation (n = 247), and heart-lung transplantation (n = 247) in seven French transplantation centers during a 12-year period were reviewed. Independent data quality control was done to ensure the quality of the collected variables. Mean graft ischemic time was 245.8 +/- 96.4 minutes (range 50-660). After adjustment on 11 potential confounders, graft ischemic time was associated with the recipient Pa(O2)/FI(O2) ratio recorded within the first 6 hours and with long-term survival in patients undergoing single or double lung transplantation but not in patients undergoing heart-lung transplantation. The relationship between graft ischemic time and survival appears to be of cubic form with a cutoff value of 330 minutes. These results were unaffected by the preservation fluid employed.

CONCLUSIONS:

The results of this large cohort of patients suggest a close relationship between graft ischemic time and both early gas exchange and long-term survival after single and double lung transplantation. Such relationship was not found in patients undergoing heart-lung transplantation. The expected graft ischemic time should be incorporated in the decision-making process at the time of graft acceptance.

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PMID:
15665320
DOI:
10.1164/rccm.200409-1248OC
[Indexed for MEDLINE]

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