1
|
Corral-Blanco M, Prudencio-Ribera VC, Jarrín-Estupiñán ME, Alonso-Moralejo R, Pérez-González V, Meneses-Pardo JC, Hermira-Anchuelo A, De Pablo-Gafas A. Influence of Pulmonary Hypertension on Intrahospital Mortality in Lung Transplantation for Interstitial Lung Disease. Transplant Proc 2019; 51:380-382. [PMID: 30879546 DOI: 10.1016/j.transproceed.2018.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 10/23/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Pulmonary hypertension (PH) is a comorbidity associated with interstitial lung disease (ILD). The purpose of this study was to evaluate the influence of PH on intrahospital mortality in lung transplantation (LT) for ILD. METHODS We conducted a retrospective cohort study of 66 patients who underwent LT for ILD at the 12 de Octubre University Hospital (Madrid, Spain) from October 2008 to June 2014. PH was defined as mean pulmonary arterial pressure (mPAP) ≥25 mmHg on right-sided heart catheterization and intrahospital mortality as any death taken place after the transplantation of patients not being discharged. RESULTS We retrospectively analyzed data of 66 patients; they were stratified by the presence or absence of PH before LT. Twenty-seven patients (41%) had PH. The PH group had a lower diffusing capacity of carbon monoxide (DLCO), carbon monoxide transfer coefficient (KCO), and 6-minute walk distance test (6MWT) and a higher total lung capacity (TLC), modified medical research council dyspnea scale (mMRC), and lung allocation score (LAS) than the non-PH group. Patients with PH more often underwent double lung transplantation (DLT; 59%) than single lung transplantation (SLT). Intrahospital mortality was 13% (9/66). No significant differences were observed in Kaplan-Meier survival curves for the PH and non-PH groups with a median survival time of 46 days versus 33 days (IQR 26-74; log-rank P = .056); however, the postoperative length of stay in the hospital was greater in the PH group. CONCLUSIONS In our cohort, pulmonary hypertension was not related to early mortality in lung transplantation recipients for interstitial lung diseases.
Collapse
Affiliation(s)
- M Corral-Blanco
- Lung Transplantation Unit, 12 de Octubre University Hospital, Madrid, Spain.
| | | | | | - R Alonso-Moralejo
- Lung Transplantation Unit, 12 de Octubre University Hospital, Madrid, Spain
| | - V Pérez-González
- Lung Transplantation Unit, 12 de Octubre University Hospital, Madrid, Spain
| | - J C Meneses-Pardo
- Lung Transplantation Unit, 12 de Octubre University Hospital, Madrid, Spain
| | - A Hermira-Anchuelo
- Lung Transplantation Unit, 12 de Octubre University Hospital, Madrid, Spain
| | - A De Pablo-Gafas
- Lung Transplantation Unit, 12 de Octubre University Hospital, Madrid, Spain
| |
Collapse
|
2
|
Prudencio-Ribera V, Corral-Blanco M, Jarrín-Estupiñán M, Alonso-Moralejo R, Pérez-González V, Martínez-Serna I, González-Serrano M, De Pablo-Gafas A. Analysis of Intrahospital Mortality in Patients With Lung Transplant Due to Diffuse Parenchymal Lung Disease. Transplant Proc 2019; 51:372-375. [DOI: 10.1016/j.transproceed.2018.10.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 10/23/2018] [Indexed: 10/28/2022]
|
3
|
Silva JT, López-Medrano F, Alonso-Moralejo R, Fernández-Ruiz M, de Pablo-Gafas A, Pérez-González V, San-Juan R, Pérez-Jacoiste Asín MA, Ruiz-Merlo T, Folgueira MD, Aguado JM. Detection of Epstein-Barr virus DNAemia after lung transplantation and its potential relationship with the development of post-transplant complications. Transpl Infect Dis 2016; 18:431-41. [PMID: 27061510 DOI: 10.1111/tid.12541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 01/25/2016] [Accepted: 03/03/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Recent studies suggest that Epstein-Barr virus DNAemia (EBVd) may act as a surrogate marker of post-transplant immunosuppression. This hypothesis has not been tested so far in lung transplant (LT) recipients. METHODS We included 63 patients undergoing lung transplantation at our center between October 2008 and May 2013. Whole blood EBVd was systematically assessed by real-time polymerase chain reaction assay on a quarterly basis. The occurrence of late complications (overall and opportunistic infection [OI] and chronic lung allograft dysfunction [CLAD]) was analyzed according to the detection of EBVd within the first 6 months post transplantation. RESULTS Any EBVd was detected in 30 (47.6%) patients. Peak EBVd was higher in patients with late overall infection (2.23 vs. 1.73 log10 copies/mL; P = 0.026) and late OI (2.39 vs. 1.74 log10 copies/mL; P = 0.004). The areas under receiver operating characteristic curves for predicting both events were 0.806 and 0.871 respectively. The presence of an EBVd ≥2 log10 copies/mL during the first 6 months post transplantation was associated with a higher risk of late OI (adjusted hazard ratio [aHR] 7.92; 95% confidence interval [CI] 2.10-29.85; P = 0.002). Patients with detectable EBVd during the first 6 months also had lower CLAD-free survival (P = 0.035), although this association did not remain statistically significant in the multivariate analysis (aHR 1.26; 95% CI 0.87-5.29; P = 0.099). CONCLUSIONS Although preliminary in nature, our results suggest that the detection of EBVd within the first 6 months after transplantation is associated with the subsequent occurrence of late OI in LT recipients.
Collapse
Affiliation(s)
- J T Silva
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
| | - F López-Medrano
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
| | - R Alonso-Moralejo
- Department of Respiratory Medicine, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), Madrid, Spain
| | - M Fernández-Ruiz
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
| | - A de Pablo-Gafas
- Department of Respiratory Medicine, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), Madrid, Spain
| | - V Pérez-González
- Department of Respiratory Medicine, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), Madrid, Spain
| | - R San-Juan
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
| | - M A Pérez-Jacoiste Asín
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
| | - T Ruiz-Merlo
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
| | - M D Folgueira
- Department of Microbiology, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), Madrid, Spain
| | - J M Aguado
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), School of Medicine, Universidad Complutense, Madrid, Spain
| |
Collapse
|
4
|
Ramos-Martínez A, Alonso-Moralejo R, Ortega-Mercader P, Sánchez-Romero I, Millán-Santos I, Romero-Pizarro Y. Pronóstico de las infecciones urinarias con tratamiento antibiótico discordante. Rev Clin Esp 2010; 210:545-9. [DOI: 10.1016/j.rce.2010.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Revised: 02/23/2010] [Accepted: 03/10/2010] [Indexed: 10/18/2022]
|