Michael Gerckens, Nicole Weiss, Daria Khmelovska, Alexander Richard, Mathias Klemm, Philipp Plohmann, Paola Arnold, Tobias Veit, Jürgen Barton, Teresa Kauke, Christian Schneider, Sebastian Michel, Michael Irlbeck, Ali Önder Yildirim, Jürgen Behr, Nikolaus Kneidinger, Carlo Mümmler
{"title":"需要胸腔穿刺的胸腔积液与肺移植受者的基线肺移植功能障碍和死亡率相关","authors":"Michael Gerckens, Nicole Weiss, Daria Khmelovska, Alexander Richard, Mathias Klemm, Philipp Plohmann, Paola Arnold, Tobias Veit, Jürgen Barton, Teresa Kauke, Christian Schneider, Sebastian Michel, Michael Irlbeck, Ali Önder Yildirim, Jürgen Behr, Nikolaus Kneidinger, Carlo Mümmler","doi":"10.1111/ctr.70234","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Pleural effusions of unknown etiology have been demonstrated to be associated with poor prognosis in lung allograft recipients. We aimed to identify novel risk factors for pleural effusions after lung transplantation (LTX) and to shed light on their association with allograft function and survival, differentiating early and late pleural effusions after LTX.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We performed a retrospective study of all LTX recipients transplanted at the LMU Klinikum Munich from 2013 to 2018. We recorded all pleural effusions requiring thoracocentesis and analyzed the corresponding clinical data. A total of 426 pleural effusions in 369 lung allograft recipients with a median follow-up time of 6.9 years were analyzed.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Both early (<90 days after LTX) and late pleural effusions (>90 days after LTX) were associated with increased mortality, with a strong mortality risk for late pleural effusions (HR 4.0). Increased mortality in patients with early pleural effusions might be mediated by a higher risk for baseline lung allograft dysfunction (BLAD). Early pleural effusions were associated with underlying obstructive disease, relative donor organ undersizing and clamshell thoracotomy. Notably, (partial) resection of the parietal pleura during LTX was not associated with pleural effusions.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>This study underlines the importance of pleural effusions after LTX. All pleural effusions were associated with increased mortality, while only early pleural effusions were associated with BLAD. The mechanisms linking pleural effusions to BLAD and to higher mortality remain unknown and will be investigated in future, prospective cohorts.</p>\n </section>\n </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70234","citationCount":"0","resultStr":"{\"title\":\"Pleural Effusions Requiring Thoracocentesis Are Associated With Baseline Lung Allograft Dysfunction and Mortality in Lung Transplant Recipients\",\"authors\":\"Michael Gerckens, Nicole Weiss, Daria Khmelovska, Alexander Richard, Mathias Klemm, Philipp Plohmann, Paola Arnold, Tobias Veit, Jürgen Barton, Teresa Kauke, Christian Schneider, Sebastian Michel, Michael Irlbeck, Ali Önder Yildirim, Jürgen Behr, Nikolaus Kneidinger, Carlo Mümmler\",\"doi\":\"10.1111/ctr.70234\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Pleural effusions of unknown etiology have been demonstrated to be associated with poor prognosis in lung allograft recipients. We aimed to identify novel risk factors for pleural effusions after lung transplantation (LTX) and to shed light on their association with allograft function and survival, differentiating early and late pleural effusions after LTX.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We performed a retrospective study of all LTX recipients transplanted at the LMU Klinikum Munich from 2013 to 2018. We recorded all pleural effusions requiring thoracocentesis and analyzed the corresponding clinical data. A total of 426 pleural effusions in 369 lung allograft recipients with a median follow-up time of 6.9 years were analyzed.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Both early (<90 days after LTX) and late pleural effusions (>90 days after LTX) were associated with increased mortality, with a strong mortality risk for late pleural effusions (HR 4.0). Increased mortality in patients with early pleural effusions might be mediated by a higher risk for baseline lung allograft dysfunction (BLAD). Early pleural effusions were associated with underlying obstructive disease, relative donor organ undersizing and clamshell thoracotomy. Notably, (partial) resection of the parietal pleura during LTX was not associated with pleural effusions.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>This study underlines the importance of pleural effusions after LTX. All pleural effusions were associated with increased mortality, while only early pleural effusions were associated with BLAD. The mechanisms linking pleural effusions to BLAD and to higher mortality remain unknown and will be investigated in future, prospective cohorts.</p>\\n </section>\\n </div>\",\"PeriodicalId\":10467,\"journal\":{\"name\":\"Clinical Transplantation\",\"volume\":\"39 8\",\"pages\":\"\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-08-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70234\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Transplantation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/ctr.70234\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Transplantation","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ctr.70234","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Pleural Effusions Requiring Thoracocentesis Are Associated With Baseline Lung Allograft Dysfunction and Mortality in Lung Transplant Recipients
Background
Pleural effusions of unknown etiology have been demonstrated to be associated with poor prognosis in lung allograft recipients. We aimed to identify novel risk factors for pleural effusions after lung transplantation (LTX) and to shed light on their association with allograft function and survival, differentiating early and late pleural effusions after LTX.
Methods
We performed a retrospective study of all LTX recipients transplanted at the LMU Klinikum Munich from 2013 to 2018. We recorded all pleural effusions requiring thoracocentesis and analyzed the corresponding clinical data. A total of 426 pleural effusions in 369 lung allograft recipients with a median follow-up time of 6.9 years were analyzed.
Results
Both early (<90 days after LTX) and late pleural effusions (>90 days after LTX) were associated with increased mortality, with a strong mortality risk for late pleural effusions (HR 4.0). Increased mortality in patients with early pleural effusions might be mediated by a higher risk for baseline lung allograft dysfunction (BLAD). Early pleural effusions were associated with underlying obstructive disease, relative donor organ undersizing and clamshell thoracotomy. Notably, (partial) resection of the parietal pleura during LTX was not associated with pleural effusions.
Conclusions
This study underlines the importance of pleural effusions after LTX. All pleural effusions were associated with increased mortality, while only early pleural effusions were associated with BLAD. The mechanisms linking pleural effusions to BLAD and to higher mortality remain unknown and will be investigated in future, prospective cohorts.
期刊介绍：
Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored.
Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include:
Immunology and immunosuppression;
Patient preparation;
Social, ethical, and psychological issues;
Complications, short- and long-term results;
Artificial organs;
Donation and preservation of organ and tissue;
Translational studies;
Advances in tissue typing;
Updates on transplant pathology;.
Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries.
Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
