General Thoracic and Cardiovascular Surgery最新文献

{"title":"Myocardial ischemia risk in Fontan candidates with pulmonary atresia with intact ventricular septum.","authors":"Naoki Masaki, Hideki Tatewaki, Satoshi Matsuo, Masaru Kumae, Kohei Yagi, Takehiko Onoki, Eiichiro Kawai, Megumi Nitta, Akira Ozawa, Sadahiro Sai","doi":"10.1007/s11748-025-02131-4","DOIUrl":"https://doi.org/10.1007/s11748-025-02131-4","url":null,"abstract":"<p><strong>Objectives: </strong>Sinusoidal communication (SC) is prevalent among Fontan candidates with pulmonary atresia with intact ventricular septum (PA/IVS), making it crucial in understanding its dynamics and potential impact on myocardial perfusion. This study aimed to assess the risk of myocardial ischemia in these patients.</p><p><strong>Methods: </strong>Sixteen Fontan candidates with PA/IVS were included in this study. All patients initially underwent Blalock-Taussig shunt (BTS), followed by bidirectional Glenn shunt in 15 cases, culminating in a total cavopulmonary connection (TCPC) at a median age of 24 months. SC severity and risk of myocardial ischemia were assessed via angiography and scintigraphy, respectively. Changes in SCs across the procedural stages and their correlation with ischemic responses in scintigraphy were retrospectively analyzed.</p><p><strong>Results: </strong>No deaths occurred during the study period. Ischemic events were observed in only one patient. SCs were observed in all 16 patients (100%). Significant regression of SCs occurred after BTS, particularly in coronary arteries with major SCs. However, no significant changes were found thereafter, particularly among coronary arteries without major SCs. No improvement or exacerbation of ischemic lesions was observed from pre- to post-TCPC. A positive correlation was revealed between angiographic SC grade and positive ischemic response on scintigraphy.</p><p><strong>Conclusions: </strong>In Fontan candidates with PA/IVS, an SC grade of 2 or higher was associated with a high risk of myocardial ischemia, emphasizing the need for careful monitoring and clinical management.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient neurologic dysfunction after aortic arch surgery.","authors":"Mesut Engin, Abdurrahman Demirel, Ahmet Kağan As, Şenol Yavuz","doi":"10.1007/s11748-024-02110-1","DOIUrl":"10.1007/s11748-024-02110-1","url":null,"abstract":"","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"198-199"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between recovery from desaturation after stair climbing and postoperative complications in lung resection.","authors":"Kensuke Takei, Hayato Konno, Shinya Katsumata, Koki Maeda, Hideaki Kojima, Mitsuhiro Isaka, Keita Mori, Yasuhisa Ohde","doi":"10.1007/s11748-024-02059-1","DOIUrl":"10.1007/s11748-024-02059-1","url":null,"abstract":"<p><strong>Objective: </strong>The stair-climbing test (SCT) is used as a surrogate for cardiopulmonary exercise testing, which measures maximal oxygen uptake, and considered a useful method for assessing exercise capacity in thoracic surgery. This study aims to investigate whether the recovery time of percutaneous oxygen saturation (SpO₂) after stair climbing is a predictor of postoperative complications after lobectomy.</p><p><strong>Methods: </strong>We retrospectively identified 54 patients who performed SCT and underwent lobectomy between January 2015 and February 2023 at Shizuoka Cancer Center. The SpO₂ recovery time was defined as the time required to recover from the minimum to resting value after stair climbing. The association between SpO₂ recovery time and early postoperative pulmonary complications within 30 days after surgery was analyzed.</p><p><strong>Results: </strong>Eleven patients (20.4%) had postoperative pulmonary complications (≥ Clavien-Dindo Classification Grade 2). The cutoff value of SpO₂ recovery time obtained from the receiver operating characteristic curve analysis was 90 s [sensitivity, 81.8%; specificity, 72.1%; AUC, 0.77 (95% confidence interval, 0.64-0.90)]. The occurrence of postoperative pulmonary complications was 42.9% in the delayed recovery time (DRT; SpO₂ recovery time ≥ 90 s) group and 6.1% in the non-DRT (SpO₂ recovery time < 90 s) group (p = 0.002). DRT was a predictor of postoperative pulmonary complications (odds ratio, 11.60; 95% CI 2.19-61.80).</p><p><strong>Conclusions: </strong>DRT of SpO₂ after stair climbing is a predictor of postoperative pulmonary complications following lobectomy in borderline patients who require exercise capacity assessment. SpO₂ monitoring after stair climbing may be useful as one of the preoperative assessments in patients undergoing lobectomy.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"171-179"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypercoagulable state and effect of low-molecular-weight heparin prophylaxis on coagulation after lung cancer resection: results from thrombo-elastography.","authors":"Xiaoxiao Yang, Yongsheng Cai, Lihui Ke, Bo Wei","doi":"10.1007/s11748-024-02062-6","DOIUrl":"10.1007/s11748-024-02062-6","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer patients undergoing surgery are at increased risk for Venous thromboembolism (VTE). We monitored changes in perioperative coagulation status through Thrombo-elastography (TEG), and monitored the anticoagulant effect of low molecular weight heparin through TEG for the first time.</p><p><strong>Methods: </strong>From July 2019 to January 2020, 207 patients receiving curative surgery were retrospectively screened. and 23 patients were excluded because they did not meet the inclusion criteria. Blood samples were required at three time points (prior to, the first and third day after surgery). Some patients were administrated nadroparin calcium daily from the first day after surgery. Repeated measures ANOVA and Chi-square test were used to analyze the coagulation states variation. To balance the confounders, propensity score matching (PSM) was used to determine the differences of coagulation states between patients with or without Low-molecular-weight heparin (LMWH) prophylaxis.</p><p><strong>Results: </strong>In 184 patients, TEG parameters displayed significant procoagulant changes after lung surgery but conventional coagulation tests exhibited paradoxical trends. There were 6.5% (12/184) of patients identified as hypercoagulability before surgery. According to TEG results, the proportion of patients with hypercoagulability rose from 21.7% to 25% postoperatively, but more were classified into platelet or mixed hypercoagulability at third day compared with that at first day (3.8% vs 14.1%, P < 0.001). By PSM analysis, there were no significant differences in the proportion of hypercoagulable patients postoperatively between chemoprophylactic and nonprophylactic group.</p><p><strong>Conclusions: </strong>TEG was eligible to distinguish changing states of hypercoagulability postoperatively and indicate the role of platelet in blood hypercoagulability. Administration of postoperative LMWH prophylaxis showed little mitigation on hypercoagulable states.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"180-189"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141765872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal membrane oxygenation vs cardiopulmonary bypass in lung transplantation: an updated meta-analysis.","authors":"Rachid Eduardo Noleto da Nobrega Oliveira, Felipe S Passos, Bernardo Mulinari Pessoa","doi":"10.1007/s11748-024-02114-x","DOIUrl":"10.1007/s11748-024-02114-x","url":null,"abstract":"<p><strong>Aim: </strong>This meta-analysis aimed to compare the outcomes of extracorporeal membrane oxygenation (ECMO) and cardiopulmonary bypass (CPB) in lung transplantation.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and Cochrane databases for studies comparing ECMO to CPB in lung transplantation. Odds ratios (ORs) for binary endpoints and mean differences (MDs) for continuous outcomes were calculated with 95% confidence intervals (CIs). DerSimonian and Laird random-effects model was applied for all endpoints. I² statistics was used to assess heterogeneity.</p><p><strong>Results: </strong>Fourteen studies with a total of 1797 patients were included. ECMO was associated with significant reductions in hepatic dysfunction (OR 0.47, 95% CI 0.25-0.90), hemodialysis (OR 0.62, 95% CI 0.43-0.88), severe graft rejection (OR 0.43, 95% CI 0.23-0.78), one-year mortality (OR 0.70; 95% CI 0.51 to 0.98; p = 0.04; I² = 13%) and tracheostomy rates (OR 0.62, 95% CI 0.46-0.86). Additionally, ECMO reduced the length of hospital stay (MD - 5.69 days, 95% CI - 9.31 to - 2.08) and ICU stay (MD - 6.02 days, 95% CI - 8.32 to - 3.71). However, ECMO was associated with longer total ischemic time (MD 61.07 min, 95% CI 3.51 to 118.62). No significant differences were observed for stroke, thromboembolic events, atrial fibrillation, or 30-day and 3-year mortality.</p><p><strong>Conclusions: </strong>ECMO offers perioperative advantages in lung transplantation, reducing postoperative complications, one-year mortality, and recovery time compared to CPB. However, the longer total ischemic time with ECMO warrants further investigation into its long-term outcomes.</p><p><strong>Trial registry: </strong>International Prospective Register of Systematic Reviews; N°: CRD42024604049; URL: https://www.crd.york.ac.uk/prospero/ .</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"137-146"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic floating thrombus in patients with COVID-19: a report of eight cases.","authors":"K Soumer, M Mallouki, N Azabou, H Horchani, S Nsiri, M Bousnina, A Jemel","doi":"10.1007/s11748-024-02072-4","DOIUrl":"10.1007/s11748-024-02072-4","url":null,"abstract":"<p><strong>Background: </strong>Thromboembolic events of COVID-19 are due to hyperinflammatory process associated with hypercoagulable state. The aim of the study was to determine characteristics and clinical outcomes of patients with COVID-19 who presented with aortic thrombus.</p><p><strong>Methods: </strong>We retrospectively conducted a single-center, descriptive study over a period of 1 year and 7 months, between June 2021 and December 2022, involving eight patients with documented SARS-CoV-2 infection associated with aortic thrombus revealed by acute limb ischemia.</p><p><strong>Results: </strong>The mean age of patients was 67 years with a median of 64, 5 ± 14. Of the eight included patients, six were men and two were women. Aortic thrombus was diagnosed in all cases. Six patients developed one episode of acute limb ischemia and one patient had recurrent upper and lower ischemia despite full anticoagulation whereas one patient had distal embolization with palpable pulses. In six patients, the thrombi were located in descending and abdominal aorta, while two patients presented with ascending aorta floating thrombus. Seven patients required urgent revascularization whereas medical treatment was recommended for one patient. The primary outcomes were successful in five cases, one patient had to be amputated above elbow, whereas two patients died due to a rapid deterioration of respiratory condition.</p><p><strong>Conclusion: </strong>Aortic thrombosis is a rare clinical presentation in SARS-CoV-2 infection but with potentially fatal embolic complication. Physicians should maintain a high degree of clinical suspicion to diagnose thromboembolic consequences of SARS-CoV-2 infection for timely management and avoiding morbidities like ischemic stroke and major amputations.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"164-170"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of temperature on transient neurologic dysfunction after total arch replacement.","authors":"Keitaro Nakanishi, Hiroshi Sato, Yutaka Iba, Ayaka Arihara, Shuhei Miura, Tsuyoshi Shibata, Jyunji Nakazawa, Tomohiro Nakajima, Takeo Hasegawa, Nobuyoshi Kawaharada","doi":"10.1007/s11748-024-02068-0","DOIUrl":"10.1007/s11748-024-02068-0","url":null,"abstract":"<p><strong>Objectives: </strong>The relationship between cooling status during aortic surgery with hypothermic circulatory arrest and postoperative neurologic dysfunction remains unknown. In the present study, we evaluated the effect of cooling status on transient neurologic dysfunction after total arch replacement.</p><p><strong>Methods: </strong>We studied patients who underwent elective total arch replacement with hypothermic circulatory arrest and antegrade selective cerebral perfusion from December 2011 to January 2021. Changes in tympanic temperature trends recorded during surgery were plotted. Several parameters, including the nadir temperature, cooling speed, and degree of cooling (cooling area, or the area under the curve of inverted temperature trends from cooling to rewarming as calculated by the integral method), were analyzed. The relationships between these variables and transient neurologic dysfunction were evaluated.</p><p><strong>Results: </strong>Transient neurologic dysfunction was observed in 33 (14.5%) of the 228 included patients. In the transient neurologic dysfunction group, the cooling area was larger (2417.3 vs. 1920.8 °C min; P < 0.001) and the cooling speed was higher (0.68 vs. 0.51 °C/min; P < 0.001) than in the non-transient neurologic dysfunction group. A multivariate logistic model revealed that both the cooling area (odds ratio = 1.13 per 100 °C min; P < 0.001) and cooling speed (odds ratio = 3.69 per °C/min; P = 0.041) were independent risk factors for transient neurologic dysfunction.</p><p><strong>Conclusions: </strong>Both the cooling area, which indicates the degree of cooling, and cooling speed had significant relationships with transient neurologic dysfunction after total arch replacement. Together, these findings indicate that overcooling and rapid cooling may contribute to brain injury.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"155-163"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro protamine addition for coagulation assessment using TEG 6s system during cardiopulmonary bypass: a pilot study.","authors":"Koichi Yoshinaga, Yusuke Iizuka, Yoshihiko Chiba, Yusuke Sasabuchi, Masamitsu Sanui","doi":"10.1007/s11748-024-02061-7","DOIUrl":"10.1007/s11748-024-02061-7","url":null,"abstract":"<p><strong>Objective: </strong>Systemic heparinization during cardiopulmonary bypass (CPB) can significantly affect thromboelastography (TEG). This study investigated the feasibility of adding protamine in vitro to allow assessment of coagulation status using the TEG 6s system during CPB.</p><p><strong>Methods: </strong>In this prospective observational study, 21 patients undergoing elective cardiac valve surgery were evaluated. During CPB, protamine was added in vitro to the heparinized blood of these patients at a concentration of 0.05 mg/mL and analyzed with the TEG 6s (Pre). The TEG parameters were compared to those analyzed after CPB withdrawal and systemic protamine administration (Post).</p><p><strong>Results: </strong>The citrated kaolin maximal amplitude (CK-MA) and the citrated functional fibrinogen maximal amplitude (CFF-MA) exhibited strong correlations between Pre and Post measurements (r = 0.790 and 0.974, respectively, P < 0.001 for both), despite significant mean differences (-2.23 mm for CK-MA and -0.68 mm for CFF-MA). Bland-Altman analysis showed a clinically acceptable agreement between Pre and Post measurement of CK-MA and CFF-MA (the percentage error was 10.6% and 12.2%, respectively). In contrast, the citrated kaolin reaction time (CK-R) showed no significant correlation between Pre and Post measurements (r = 0.328, P = 0.146), with a mean difference of 1.42 min (95% CI: -0.45 to 3.29).</p><p><strong>Conclusions: </strong>In vitro protamine addition allows assessment of coagulation status during CPB using the TEG 6s system. CK-MA and CFF-MA measured during CPB using this method revealed a strong correlation and agreement with post-CPB measurements, suggesting that our method potentially facilitates early prediction of post-CPB coagulation status and decision-making on transfusion strategies.</p><p><strong>Clinical trial registration: </strong>The study was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR, registration number: UMIN000041097, date of registration: July 13, 2020, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000046925 ) before the recruitment of participants.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":"147-154"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of postoperative pain between robotic and uniportal video-assisted thoracic surgery for anatomic lung resection in patients with stage I lung cancer.","authors":"Keita Tokuishi, Jun-Ichi Wakahara, Yuichiro Ueda, So Miyahara, Hiroyasu Nakashima, Yoshiko Masuda, Ryuichi Waseda, Takeshi Shiraishi, Toshihiko Sato","doi":"10.1007/s11748-025-02129-y","DOIUrl":"https://doi.org/10.1007/s11748-025-02129-y","url":null,"abstract":"<p><strong>Objective: </strong>Uniportal video-assisted thoracoscopic surgery (U-VATS) and robot-assisted thoracoscopic surgery (RATS) are widely used, minimally invasive procedures. The present study aimed to compare postoperative pain following U-VATS and RATS anatomical lung resection in patients with clinical stage I lung cancer.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of the data from 133 patients with clinical stage I lung cancer who underwent U-VATS (n = 63), four-arm RATS (n = 70) lobectomy, or segmentectomy between August 2020 and August 2023. Early postoperative outcomes, pain scores through postoperative day 7, and duration of postoperative analgesic use 60 days after surgery were compared using propensity score-matched analysis.</p><p><strong>Results: </strong>In the propensity score-matched analysis, the U-VATS group had a shorter operative time than the RATS group (160 vs. 202 min, respectively; P < 0.001). However, no significant differences were observed in blood loss, chest tube duration, complications, post operative stay length, or number of dissected lymph nodes and stations. The U-VATS group exhibited significantly lower pain scores than the RATS group throughout the entire postoperative period, particularly on postoperative days 1, 2, 3, 4, 5, and 7(P = 0.006, 0.044, 0.032, 0.041, 0.007, and 0.024, respectively). The number of patients who used analgesics for at least 2 months was lower in the U-VATS group than in the RATS group (4 [8.2%] vs. 17 [34.0%], respectively; P = 0.002).</p><p><strong>Conclusion: </strong>U-VATS anatomical lung resection in patients with clinical stage I lung cancer has less postoperative pain than RATS.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in serum KL-6 levels following lung transplantation for interstitial lung diseases.","authors":"Kazuhisa Matsumoto, Akihiro Ohsumi, Tomohiro Handa, Daisuke Nakajima, Satona Tanaka, Satoshi Hamada, Kohei Ikezoe, Kiminobu Tanizawa, Toyohiro Hirai, Hiroshi Date","doi":"10.1007/s11748-025-02117-2","DOIUrl":"https://doi.org/10.1007/s11748-025-02117-2","url":null,"abstract":"<p><strong>Objective: </strong>To assess the changes in Krebs von den Lungen-6 (KL-6) levels pre- and post-lung transplantation for interstitial lung disease and to determine the connection between changes in KL-6 levels and chronic lung allograft dysfunction.</p><p><strong>Methods: </strong>Eighty-two lung transplantation procedures were performed in interstitial lung disease patients between January 2008 and December 2019. We compared changes in KL-6 levels before and after transplantation in two groups: unilateral and bilateral lung transplant groups. Additionally, KL-6 levels just before or at the onset of chronic lung allograft dysfunction were compared to the lowest post-transplant levels.</p><p><strong>Results: </strong>In total, 28 female and 49 male patients (median age: 54 years; range 22-64; 42 and 35 patients underwent unilateral and bilateral lung transplantations, respectively) were enrolled. The post-transplant observation period ranged from 8 to 163 (median: 64.2) months. KL-6 levels decreased in 76 patients (98.7%). Notably, the KL-6 level was lower in the bilateral lung transplantation group than in the unilateral lung transplantation group. Moreover, KL-6 levels were higher just before or at the onset of chronic lung allograft dysfunction than the lowest post-transplant levels. These levels were significantly higher than the highest post-transplant levels observed in the non-chronic lung allograft dysfunction group.</p><p><strong>Conclusions: </strong>Our findings suggest that KL-6 levels decrease in interstitial lung disease patients following lung transplantation, with a greater reduction in KL-6 levels observed in bilateral lung transplantation compared to unilateral lung transplantation. Elevated serum KL-6 levels were associated with chronic lung allograft dysfunction, highlighting its utility as a diagnostic biomarker.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}