Michał Jan Kubisa, Małgorzata Edyta Wojtyś, Piotr Lisowski, Dawid Kordykiewicz, Maria Piotrowska, Janusz Wójcik, Jarosław Pieróg, Krzysztof Safranow, Tomasz Grodzki, Bartosz Kubisa
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引用次数: 0
摘要
背景：原发性移植物功能障碍（PGD）是肺移植术（LuTx）后 72 小时内发生的一种急性肺损伤（ALI），是肺移植术最常见的早期并发症。PGD根据动脉血氧分压与吸入氧分压的比值和胸部X光片结果进行诊断和分级。PGD 3 级会增加受者死亡率和慢性肺移植功能障碍（CLAD）的几率：这项回顾性研究旨在确定新的 PGD 风险因素。符合纳入标准的59名患者均于2010年至2018年间在同一中心接受了移植手术。供体数据来自波兰国家移植登记处提供的记录，并按三种变量进行分析：PGD 1-3 vs. PGD 0、PGD 3 vs. PGD 0和PGD 3 vs. PGD 0-2：结果：采用多因素逻辑回归模型确定了受体年龄越小、供体体重指数越高和供体中心静脉压（CVP）越高为PGD（1-3级）的风险因素：结论：较长的冷缺血时间（CIT）和较高的供体中心静脉压被证明是 PGD 3 的独立风险因素。
Analysis of Primary Graft Dysfunction (PGD) Risk Factors in Lung Transplantation (LuTx) Patients.
Background: Primary graft dysfunction (PGD) is a form of acute lung injury (ALI) that occurs within 72 h after lung transplantation (LuTx) and is the most common early complication of the procedure. PGD is diagnosed and graded based on the ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen and chest X-ray results. PGD grade 3 increases recipient mortality and the chance of chronic lung allograft dysfunction (CLAD).
Method: The aim of this retrospective study was to identify new PGD risk factors. The inclusion criteria were met by 59 patients, who all received transplants at the same center between 2010 and 2018. Donor data were taken from records provided by the Polish National Registry of Transplantation and analyzed in three variants: PGD 1-3 vs. PGD 0, PGD 3 vs. PGD 0 and PGD 3 vs. PGD 0-2.
Results: A multiple-factor logistic regression model was used to identify decreasing recipient age; higher donor BMI and higher donor central venous pressure (CVP) for the PGD (of the 1-3 grade) risk factor.
Conclusions: Longer cold ischemia time (CIT) and higher donor CVP proved to be independent risk factors of PGD 3.
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