Time on the waiting list is an independent risk factor for day-90 mortality after lung transplantation

IF 3.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine Pub Date : 2025-02-21 DOI:10.1016/j.accpm.2025.101499

Enora Atchade , Vincent Bunel-Gourdy , Nathalie Zappella , Sylvain Jean-Baptiste , Alexy Tran-Dinh , Sébastien Tanaka , Brice Lortat-Jacob , Arnaud Roussel , Pierre Mordant , Yves Castier , Hervé Mal , Christian De Tymowski , Philippe Montravers

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引用次数: 0

Abstract

Background

The waitlist deaths of transplantation candidates based on their time on the waiting list (TWL) have already been studied, but the short-term mortality and early complications of lung transplant (LT) recipients based on their TWL have not been specifically studied. The first aim of this study was to assess the relationship between increased TWL and short-term mortality in LT recipients.

Methods

In this observational, monocentric, retrospective study, all patients who underwent LT between January 2016 and August 2022 at Bichat Claude Bernard Hospital, Paris were analyzed. Univariate analysis (chi2 test, Mann–Whitney test, Fisher’s exact test) and multivariate analysis (logistic regression) were performed. Ninety-days and one-year survival were studied (Kaplan–Meier curves, log-rank test). p < 0.05 indicated statistical significance.

Results

242 LT patients were analyzed. The median TWL was 100 (43−229) days. Postoperative complications, including septic shock (36 versus 18%, p = 0.002), grade 3 primary graft dysfunction (31 versus 20%, p < 0.001), and KDIGO3 acute kidney injury (8 versus 25%, p < 0.001), were more common in the prolonged TWL (pTWL) group (>100 days) than in the short TWL group (≤100 days). The duration of hospitalization in the ICU was longer (18 [11−34] versus 13 [9−23] days, p = 0.02) in the pTWL group. According to our multivariate analysis, TWL was an independent risk factor for 90-days mortality (OR 1.02, 95% CI [1.00−1.04]; p = 0.032).

Conclusion

TWL was an independent risk factor for 90-days mortality after LT. Receiving LT after more than 100 days on the waitlist exposes to increased postoperative complications.

查看原文本刊更多论文

等待名单上的时间是肺移植术后90天死亡率的独立危险因素。

背景：基于等待名单时间（TWL）的移植候选者等待名单死亡已经有研究，但基于等待名单时间（TWL）的肺移植（LT）受者短期死亡率和早期并发症尚未有专门研究。本研究的第一个目的是评估肝移植受者TWL增加与短期死亡率之间的关系。方法：在这项观察性、单中心、回顾性研究中，对2016年1月至2022年8月在巴黎Bichat Claude Bernard医院接受肝移植的所有患者进行分析。进行单因素分析（chi2检验、Mann-Whitney检验、Fisher精确检验）和多因素分析（logistic回归）。研究90天和1年生存率（Kaplan-Meier曲线，log-rank检验）。P < 0.05为有统计学意义。结果：242例LT患者进行了分析。中位TWL为100（43-229）天。术后并发症，包括感染性休克（36% vs 18%, p = 0.002）， 3级原发性移植物功能障碍（31% vs 20%, p = 100天），较短TWL组（≤100天）。pTWL组在ICU的住院时间更长（18[11-34]天和13[9-23]天，p = 0.02）。根据我们的多因素分析，TWL是90天死亡率的独立危险因素(OR 1.02, 95% CI [1.00-1.04]；p = 0.032)。结论：TWL是肝移植后90天死亡率的独立危险因素。等待肝移植超过100天后接受肝移植会增加术后并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anaesthesia Critical Care & Pain Medicine ANESTHESIOLOGY-

CiteScore

6.70

自引率

5.50%

发文量

150

审稿时长

18 days

期刊介绍： Anaesthesia, Critical Care & Pain Medicine (formerly Annales Françaises d''Anesthésie et de Réanimation) publishes in English the highest quality original material, both scientific and clinical, on all aspects of anaesthesia, critical care & pain medicine.