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Gil Barturen M, Laporta Hernández R, Romero Berrocal A, Pérez Redondo M, Gómez Lozano N, Martín López J, Royuela Vicente A, Romero Román A, Hoyos Mejía L, Crowley Carrasco S, Gómez de Antonio D, Naranjo Gómez JM, Córdoba Peláez M, Novoa NM, Campo-Cañaveral de la Cruz JL. Donor Lung Preservation at 10°C: Clinical and Logistical Impact. Arch Bronconeumol 2024:S0300-2896(24)00081-4. [PMID: 38644153 DOI: 10.1016/j.arbres.2024.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/05/2023] [Revised: 02/24/2024] [Accepted: 03/31/2024] [Indexed: 04/23/2024]
Abstract
INTRODUCTION Cold static donor lung preservation at 10°C appears to be a promising method to safely extend the cold ischemic time (CIT) and improve lung transplant (LTx) logistics. METHODS LTx from November 2021 to February 2023 were included in this single institution, prospective, non-randomized study comparing prolonged preservation at 10°C versus standard preservation on ice. The inclusion criteria for 10°C preservation were suitable grafts for LTx without any donor retrieval concerns. PRIMARY ENDPOINT primary graft dysfunction (PGD) grade-3 at 72-h. Secondary endpoints: clinical outcomes, cytokine profile and logistical impact. RESULTS Thirty-three out of fifty-seven cases were preserved at 10°C. Donor and recipient characteristics were similar across the groups. Total preservation times (h:min) were longer (p<0.001) in the 10°C group [1st lung: median 12:09 (IQR 9:23-13:29); 2nd: 14:24 (12:00-16:20)] vs. standard group [1st lung: median 5:47 (IQR 5:18-6:40); 2nd: 7:15 (6:33-7:40)]. PGD grade-3 at 72-h was 9.4% in 10°C group vs. 12.5% in standard group (p=0.440). Length of mechanical ventilation (MV), ICU and hospital stays were similar in both groups. Thirty and ninety-day mortality rates were 0% in 10°C group (vs. 4.2% in standard group). IL-8 concentration was significantly higher 6-h post-LTx in the standard group (p=0.025) and IL-10 concentration was increased 72-h post-LTx in the 10°C group (p=0.045). CONCLUSIONS Preservation at 10°C may represent a safe and feasible strategy to intentionally prolong the CIT. In our center, extending the CIT at 10°C may allow for semi-elective LTx and improve logistics with similar outcomes compared to the current standard preservation on ice.
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Affiliation(s)
- Mariana Gil Barturen
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | | | | | - Marina Pérez Redondo
- Transplant Coordination and Intensive Care Unit, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Natalia Gómez Lozano
- Immunology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Javier Martín López
- Pathology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Ana Royuela Vicente
- Biostatistics Unit; Puerta de Hierro Biomedical Research Institute (IDIPHISA), CIBERESP, Madrid, Spain
| | - Alejandra Romero Román
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Lucas Hoyos Mejía
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Silvana Crowley Carrasco
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - David Gómez de Antonio
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Jose Manuel Naranjo Gómez
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Mar Córdoba Peláez
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Nuria María Novoa
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Jose Luis Campo-Cañaveral de la Cruz
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Spain; Universidad Europea de Madrid, Department of Medicine, Spain.
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Romero Román A, Gil Barturen M, Crowley Carrasco S, Hoyos Mejía L, Naranjo Gómez JM, Córdoba Peláez M, Pérez Redondo M, Royuela Vicente A, García Fadul C, Gómez de Antonio D, Novoa NM, Campo-Cañaveral de la Cruz JL. Outcomes after lung transplantation from selected donors older than 70 years in a single centre: time to close the debate? Eur J Cardiothorac Surg 2024; 65:ezae077. [PMID: 38439563 DOI: 10.1093/ejcts/ezae077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 02/12/2024] [Accepted: 02/29/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVES The aim of this study was to compare the outcomes of lung transplantations using grafts from donors aged over 70 years against those performed using younger donors. METHODS This retrospective single-centre analysis includes lung transplants conducted at our institution from January 2014 to June 2022. Lung recipients were classified into 2 groups based on donor age (group A <70 years; group B ≥70 years). Variables regarding demographics, peri and postoperative outcomes and survival were included. The statistical analysis approach included univariable analysis, propensity score matching to address imbalances in donor variables (smoking status), recipient characteristics (sex, age, diagnosis and lung allocation score) and calendar period and survival analysis. RESULTS A total of 353 lung transplants were performed in this period, 47 (13.3%) using grafts from donors aged over 70 years. Donors in group B were more frequently women (70.2% vs 51.6%, P = 0.017), with less smoking history (22% vs 43%, P = 0.002) and longer mechanical ventilation time (3 vs 2 days, P = 0.025). Recipients in group B had a higher lung allocation score (37.5 vs 35, P = 0.035). Postoperative variables were comparable between both groups, except for pulmonary function tests. Group B demonstrated lower forced expiratory volume 1 s levels (2070 vs 2580 ml, P = 0.001). The propensity score matching showed a lower chance of chronic lung allograft dysfunction by 12% for group B. One-, three- and five-year survival was equal between the groups. CONCLUSIONS The use of selected expanded-criteria donors aged over 70 years did not result in increased postoperative morbidity, early mortality or survival in this study.
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Affiliation(s)
- Alejandra Romero Román
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Mariana Gil Barturen
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Silvana Crowley Carrasco
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Lucas Hoyos Mejía
- Thoracic Surgery and Lung Transplantation Department, University Hospital Zurich, Zurich, Switzerland
| | - Jose Manuel Naranjo Gómez
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Mar Córdoba Peláez
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Marina Pérez Redondo
- Transplant Coordinator, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Ana Royuela Vicente
- Biostatistics Unit, Puerta de Hierro Biomedical Research Institute (IDIPHISA), CIBERESP, Madrid, Spain
| | - Christian García Fadul
- Pneumology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - David Gómez de Antonio
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Nuria María Novoa
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Jose Luis Campo-Cañaveral de la Cruz
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
- Faculty of Medicine, Universidad Europea de Madrid, Madrid, Spain
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Campo-Cañaveral de la Cruz JL, Miñambres E, Coll E, Padilla M, Sánchez Antolín G, de la Rosa G, Rosado J, González García FJ, Crowley Carrasco S, Sales Badía G, María Fieria Costa E, Alberto García Salcedo J, Mora V, de la Torre C, Badenes R, Atutxa Bizkarguenaga L, Domínguez-Gil B. Outcomes Of Lung And Liver Transplantation After Simultaneous Recovery Using Abdominal Normothermic Regional Perfusion In Donors After The Circulatory Determination Of Death Versus Donors After Brain Death. Am J Transplant 2023:S1600-6135(23)00414-8. [PMID: 37100392 DOI: 10.1016/j.ajt.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 04/28/2023]
Abstract
Normothermic regional perfusion (NRP) in controlled donation after the circulatory determination of death (cDCD) is a growing preservation technique for abdominal organs that coexists with the rapid recovery of lungs. We aim at describing the outcomes of lung transplants (LuTx) and liver transplants (LiTx) when both grafts are simultaneously recovered from cDCD donors using NRP, and compare them to donation after brain death (DBD). All LuTx and LiTx meeting these criteria during January-2015 to December-2020 in Spain were included in the study. Simultaneous recovery of lungs and livers was undertaken in 227 (17%) cDCD with NRP and 1,879 (21%) DBD donors (p<0.001). Primary graft dysfunction grade-3 within the first 72hours was similar in both LuTx groups (14.7% cDCD vs. 10.5% DBD;p=0.139). LuTx survival at 1 and 3years was 79.9% and 66.4% in cDCD, vs. 81.9% and 69.7% in DBD (p=0.403). The incidence of primary non-function and ischemic cholangiopathy was similar in both LiTx groups. Graft survival at 1 and 3years was 89.7% and 80.8% in cDCD vs. 88.2% and 82.1% in DBD LiTx (p=0.669). In conclusion, the simultaneous rapid recovery of lungs and preservation of abdominal organs with NRP in cDCD donors is feasible, and offers similar outcomes in both LuTx and LiTx recipients to transplants using DBD grafts.
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Affiliation(s)
| | - Eduardo Miñambres
- Transplant Coordination Unit & Service of Intensive Care, University Hospital Marqués de Valdecilla-IDIVAL. School of Medicine, Universidad de Cantabria, Santander, Spain
| | | | | | | | | | - Joel Rosado
- Thoracic Surgery and Lung Transplantation. Vall d'Hebrón University Hospital. Barcelona, Spain
| | | | - Silvana Crowley Carrasco
- Thoracic Surgery and Lung Transplantation Department. Hospital Universitario Puerta de Hierro-Majadahonda. Madrid, Spain
| | - Gabriel Sales Badía
- Thoracic Surgery and Lung Transplantation. Hospital Universitari i Politècnic La Fe. Valencia, Spain
| | - Eva María Fieria Costa
- Thoracic Surgery and Lung Transplantation. Complejo Hospitalario Universitario A Coruña. A Coruña, Spain
| | | | - Victor Mora
- Pneumology Department, Lung Transplantation Unit, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Carlos de la Torre
- Pediatric Surgery and Lung Transplantation. La Paz University Hospital. Madrid, Spain
| | - Rafael Badenes
- Department of Anesthesiology and Surgical-Trauma Intensive Care, Hospital Clinic Universitari de Valencia, University of Valencia, Valencia, Spain
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Romero Román A, Crowley Carrasco S, Gil Barturen M, Royuela A, Obiols C, Call S, Recuero JL, Royo Í, Embún R, Gómez de Antonio D. Pathological N1/N2 in Clinical Stage I Bronchogenic Carcinoma. Analysis From a Prospective Multicentre Database. Arch Bronconeumol 2023:S0300-2896(23)00109-6. [PMID: 37005150 DOI: 10.1016/j.arbres.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/05/2023] [Accepted: 03/14/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVES To determine the incidence of occult N1/N2 nodal metastases and associated risk factors in patients with non-small cell lung cancer no larger than 3cm and deemed cN0 by CT and PET-CT in a prospective, multicentre national database. METHODS Patients with a NSCLC no larger than 3cm, deemed cN0 by PET-CT and CT scan, who had undergone at least a lobectomy, were selected from a national multicentre database of 3533 patients who had undergone anatomic lung resection between 2016 and 2018. Clinical and pathological variables of patients with pN0 and patients with pN1/N2 were compared to identify factors associated with the presence of lymph node metastases. Chi2 and the Mann-Whitney U test were used for categorical and numerical variables, respectively. All variables with p<0.2 in the univariate analysis were included in the multivariate logistic regression analysis. RESULTS The study included 1205 patients from the cohort. The incidence of occult pN1/N2 disease was 10.70% (95%CI, 9.01-12.58). The multivariable analysis revealed that the degree of differentiation, size, location (central or peripheral) and SUV of the tumour in PET, surgeon experience and number of lymph nodes resected were associated with occult N1/N2 metastases. CONCLUSIONS The incidence of occult N1/N2 in patients with bronchogenic carcinoma with cN0 tumours no larger than 3cm is no negligible. Data about the degree of differentiation, tumour size in CT scan, maximal uptake of the tumour in PET-CT, location (central or peripheral), number of lymph nodes resected and surgeon seniority is relevant in order to detect patients at risk.
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Affiliation(s)
- Alejandra Romero Román
- Thoracic Surgery Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
| | | | - Mariana Gil Barturen
- Thoracic Surgery Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Ana Royuela
- Biostatistics Unit, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), CIBERESP, Madrid, Spain
| | - Carme Obiols
- Thoracic Surgery Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Terrassa, Spain
| | - Sergi Call
- Thoracic Surgery Department, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Terrassa, Spain
| | - José Luis Recuero
- Thoracic Surgery Department, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, Spain
| | - Íñigo Royo
- Thoracic Surgery Department, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, Spain
| | - Raúl Embún
- Thoracic Surgery Department, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, Spain
| | - David Gómez de Antonio
- Thoracic Surgery Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
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Gil Barturen M, Laporta Hernández R, Romero Berrocal A, Pérez Redondo M, Romero Román A, Crowley Carrasco S, Hoyos Mejía L, Cordero Iglesias P, Naranjo Gómez JM, Córdoba Peláez M, Gómez de Antonio D, Campo-Cañaveral de la Cruz JL. Donor lungs cold preservation at 10 °C offers a potential logistic advantage in lung transplantation. Cir Esp 2022; 101:283-286. [PMID: 36417996 DOI: 10.1016/j.cireng.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 08/09/2022] [Revised: 10/04/2022] [Accepted: 10/12/2022] [Indexed: 11/21/2022]
Abstract
Donor lung preservation at 10 °C appears to be an innovative and promising method that may improve transplant logistics by extending the cold ischemia time with excellent outcomes. We report the case of two lung transplants from two different donors involving the use of two different preservation methods, highlighting the benefits of using 10 °C lung storage.
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Affiliation(s)
- Mariana Gil Barturen
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | | | - Antonio Romero Berrocal
- Anesthesiology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Marina Pérez Redondo
- Transplant Coordinator, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Alejandra Romero Román
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Silvana Crowley Carrasco
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Lucas Hoyos Mejía
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Pablo Cordero Iglesias
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Jose Manuel Naranjo Gómez
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Mar Córdoba Peláez
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - David Gómez de Antonio
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
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Barturen MG, Campo-Cañaveral de la Cruz JL, Crowley Carrasco S, Romero Román A, Hoyos Mejía L, Peyró M, Díaz Nuevo G, López García-Gallo C, Pérez Redondo M, Royuela Vicente A, Tanaka S, Naranjo Gómez JM, Córdoba Peláez M, Varela de Ugarte A, Gómez de Antonio D. Interrupted Versus Continuous Suture for Bronchial Anastomosis in Lung Transplantation: Does It Matter? Eur J Cardiothorac Surg 2022; 62:6747957. [PMID: 36193995 DOI: 10.1093/ejcts/ezac493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Bronchial anastomotic complications remain a major concern in lung transplantation. We aim to compare two different techniques, continuous versus interrupted suture by analyzing airway complications requiring intervention. METHODS Lung transplantations between January-2015 and December-2020 were included. Airway complications requiring intervention were classified following the 2018 ISHLT consensus and analyzed comparing three groups of patients according to surgical technique: Group A, both anastomosis performed with continuous suture; Group B, both with interrupted; and Group C, interrupted suture for one side and continuous suture for the contralateral side. RESULTS A total of 461 anastomoses were performed in 245 patients. The incidence of airway complications requiring intervention was 5.7% (95%CI 2.8; 8.6) per patient (14/245) and 3.7% (95%CI 2.0; 5.4) per anastomosis (17/461). Complications that required intervention were present in 5 out of 164 (3.1%) anastomosis with interrupted technique, and in 12/240 (5%) with continuous suture. No significant differences were found between techniques (p = 0.184). No statistical differences were found among Group A, B or C in terms of incidence of anastomotic complications, demographics, transplant outcomes or overall survival (log-rank p = 0.513). In a multivariable analysis, right laterality was significantly associated to complications requiring intervention (OR 3.7[CI 95%:1.1-12.3], p = 0.030). Endoscopic treatment was successful in 12 patients (85.7%). Retransplantation was necessary in two patients. CONCLUSION In summary, although it seems that anastomotic complications requiring intervention occur more frequently with continuous suture, there are no statistical differences compared to interrupted suture. Endoscopic treatment offers good outcomes in most of the airway complications after lung transplantation.
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Affiliation(s)
- Mariana Gil Barturen
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda
| | | | - Silvana Crowley Carrasco
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda
| | - Alejandra Romero Román
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda
| | - Lucas Hoyos Mejía
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda
| | - María Peyró
- Thoracic Surgery Department, Hospital Universitario de Albacete
| | - Gema Díaz Nuevo
- Pneumology Department, Hospital Universitario Puerta de Hierro-Majadahonda
| | | | - Marina Pérez Redondo
- Transplant Coordination and Intensive Care Unit, Hospital Universitario Puerta de Hierro-Majadahonda
| | - Ana Royuela Vicente
- Biostatistics Unit; Puerta de Hierro Biomedical Research Institute (IDIPHISA); CIBERESP, Madrid. Spain
| | | | - Jose Manuel Naranjo Gómez
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda
| | - Mar Córdoba Peláez
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda
| | - Andrés Varela de Ugarte
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda
| | - David Gómez de Antonio
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda
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Tanaka S, Hoyos Mejía L, Romero Román A, Campo-Cañaveral de la Cruz JL, Crowley Carrasco S, Naranjo Gómez JM, Córdoba Peláez MDM, Sánchez Calle Á, Gil Barturen M, Varela de Ugarte A, Gómez-de-Antonio D. Evaluation of Uncontrolled Donation After Circulatory Death Lungs by Conventional In Situ Effluent Gas Analysis and Ex Vivo Lung Perfusion. Arch Bronconeumol 2022; 58:569-571. [PMID: 35312549 DOI: 10.1016/j.arbres.2021.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/03/2021] [Accepted: 06/10/2021] [Indexed: 11/02/2022]
Affiliation(s)
- Shin Tanaka
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Calle Manuel de Falla s/n, Majadahonda, Madrid 28222, Spain
| | - Lucas Hoyos Mejía
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Calle Manuel de Falla s/n, Majadahonda, Madrid 28222, Spain.
| | - Alejandra Romero Román
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Calle Manuel de Falla s/n, Majadahonda, Madrid 28222, Spain
| | - Jose Luis Campo-Cañaveral de la Cruz
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Calle Manuel de Falla s/n, Majadahonda, Madrid 28222, Spain
| | - Silvana Crowley Carrasco
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Calle Manuel de Falla s/n, Majadahonda, Madrid 28222, Spain
| | - Jose Manuel Naranjo Gómez
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Calle Manuel de Falla s/n, Majadahonda, Madrid 28222, Spain
| | - Maria Del Mar Córdoba Peláez
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Calle Manuel de Falla s/n, Majadahonda, Madrid 28222, Spain
| | - Álvaro Sánchez Calle
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Calle Manuel de Falla s/n, Majadahonda, Madrid 28222, Spain
| | - Mariana Gil Barturen
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Calle Manuel de Falla s/n, Majadahonda, Madrid 28222, Spain
| | - Andrés Varela de Ugarte
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Calle Manuel de Falla s/n, Majadahonda, Madrid 28222, Spain
| | - David Gómez-de-Antonio
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Calle Manuel de Falla s/n, Majadahonda, Madrid 28222, Spain
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Gómez de Antonio D, Crowley Carrasco S, Romero Román A, Royuela A, Calle ÁS, Obiols Fornell C, Call Caja S, Embún R, Royo Í, Recuero JL, Cabañero A, Moreno N, Bolufer S, Congregado M, Jimenez MF, Aguinagalde B, Amor-Alonso S, Arrarás MJ, Blanco Orozco AI, Boada M, Cal I, Cilleruelo Ramos Á, Fernández-Martín E, García-Barajas S, García-Jiménez MD, García-Prim JM, Garcia-Salcedo JA, Gelbenzu-Zazpe JJ, Giraldo-Ospina CF, Gómez Hernández MT, Hernández J, Wolf JDI, Jáuregui Abularach A, Jiménez U, López Sanz I, Martínez-Hernández NJ, Martínez-Téllez E, Milla Collado L, Mongil Poce R, Moradiellos-Díez FJ, Moreno-Basalobre R, Moreno Merino SB, Quero-Valenzuela F, Ramírez-Gil ME, Ramos-Izquierdo R, Rivo E, Rodríguez-Fuster A, Rojo-Marcos R, Sanchez-Lorente D, Sánchez Moreno L, Simón C, Trujillo-Reyes JC, López García C, Fibla Alfara JJ, Sesma Romero J, Hernando Trancho F. [Translated article] Surgical Risk Following Anatomic Lung Resection in Thoracic Surgery: A Prediction Model Derived From a Spanish Multicenter Database. Arch Bronconeumol 2022. [DOI: 10.1016/j.arbres.2021.01.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Obiols C, Call S, Rami-Porta R, Jaén Á, Gómez de Antonio D, Crowley Carrasco S, Royo-Crespo Í, Embún R. Radicality of lymphadenectomy in lung cancer resections by thoracotomy and video-assisted thoracoscopic approach: A prospective, multicentre and propensity-score adjusted study. Lung Cancer 2022; 165:63-70. [PMID: 35091211 DOI: 10.1016/j.lungcan.2022.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 10/16/2021] [Revised: 12/20/2021] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To analyse differences in intraoperative nodal assessment in patients undergoing lung cancer resection by thoracotomy and video-assisted thoracoscopy (VATS) in the Spanish Video-Assisted Thoracic Surgery Group (GEVATS). METHODS Prospective multicentre cohort study of anatomic pulmonary resections (n = 3533) performed from December 2016 to March 2018. Main surgical, clinical and oncological variables related with lymphadenectomy were compared according to surgical approach. Corresponding tests for homogeneity were performed. Multiple logistic regression analyses were used to determine the odds ratio (OR) and 95% confidence interval (95%CI). Covariate adjustment using the propensity score (PS) was performed to reduce confounding effects. RESULTS After exclusions, 2532 patients were analysed. Systematic nodal dissection (SND) was performed in 65%, with a median of resected/sampled lymph nodes (LN) of 7 (IQR 4-12) and pathologic (p) N2 and uncertain (u) pNu rates of 9.4% and 28.9%, respectively. At multivariate analysis, the following were associated with thoracotomy (OR; 95%CI): SND (1.4; 1.08-1.96; p = 0.014), staging mediastinoscopy (2.6; 1.59-4.25; p < 0.001), tumor > 3 cm (2.1; 1.66-2.78; p < 0.001), central tumor (2.5; 1.90-3.24; p < 0.001); pN1 (1.8; 1.25-2.67; p < 0.002), pN2 (1.8; 1.18-2.76; p = 0.006), lower FEV1 (0.9; 0.98-0.99; p < 0.001), squamous cell carcinoma (1.5; 1.16-1.98; p = 0.002) and inexperienced surgeons in VATS (compared with > 100 VATS experience) (37.6; 13.55-104.6; p < 0.001). After PS adjustment, SND maintained the OR, but in the limit of signification (1.4; 1-1.98; p = 0.05). Nodal upstaging was significantly higher in the thoracotomy group. Complication rates of SND and no SND were similar. CONCLUSIONS Thoracotomy was associated with a more thorough lymphadenectomy in GEVATS. Therefore, intraoperative lymph node evaluation performed at VATS should be improved to have better prognostic information and more solid grounds to indicate adjuvant therapy.
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Affiliation(s)
- Carme Obiols
- Department of Thoracic Surgery, Hospital Universitari Mútua Terrassa, University of Barcelona, Terrassa, Spain.
| | - Sergi Call
- Department of Thoracic Surgery, Hospital Universitari Mútua Terrassa, University of Barcelona, Terrassa, Spain; Department of Morphological Sciences, Medical School, Autonomous University of Barcelona, Bellaterra, Spain
| | - Ramón Rami-Porta
- Department of Thoracic Surgery, Hospital Universitari Mútua Terrassa, University of Barcelona, Terrassa, Spain; Network of Centres of Biomedical Research in Respiratory Diseases (CIBERES), Lung Cancer Group, Terrassa, Spain
| | - Ángeles Jaén
- Unit of Research. Fundació Docència i Recerca Mútua Terrassa, University of Barcelona, Terrassa, Spain
| | - David Gómez de Antonio
- Department of Thoracic Surgery, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Silvana Crowley Carrasco
- Department of Thoracic Surgery, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Íñigo Royo-Crespo
- Department of Thoracic Surgery, IIS Aragón, Hospital Universitario Miguel Servet and Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Raúl Embún
- Department of Thoracic Surgery, IIS Aragón, Hospital Universitario Miguel Servet and Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
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Campo-Cañaveral de la Cruz JL, Crowley Carrasco S, Tanaka S, Romero Román A, Hoyos Mejía L, Gil Barturen M, Sánchez Calle Á, García Fadul C, Aguilar Pérez M, Pérez Redondo M, Naranjo Gómez JM, Royuela A, Córdoba Peláez M, Varela de Ugarte A, Gómez de Antonio D. Lung transplantation from uncontrolled and controlled donation after circulatory death: similar outcomes to brain death donors. Transpl Int 2021; 34:2609-2619. [PMID: 34570381 DOI: 10.1111/tri.14120] [Citation(s) in RCA: 1] [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: 05/24/2021] [Revised: 09/20/2021] [Accepted: 09/20/2021] [Indexed: 11/26/2022]
Abstract
Controlled donation after circulatory death donors (cDCD) are becoming a frequent source of lungs grafts worldwide. Conversely, lung transplantations (LTx) from uncontrolled donors (uDCD) are sporadically reported. We aimed to review our institutional experience using both uDCD and cDCD and compare to LTx from brain death donors (DBD). This is a retrospective analysis of all LTx performed between January 2013 and December 2019 in our institution. Donor and recipient characteristics were collected and univariate, multivariate and survival analyses were carried out comparing the three cohorts of donors. A total of 239 (84.7%) LTx were performed from DBD, 29 (10.3%) from cDCD and 14 (5%) from uDCD. There were no statistically significant differences in primary graft dysfunction grade 3 at 72 h, 30- and 90-day mortality, need for extracorporeal membrane oxygenation after procedure, ICU and hospital length of stay, airway complications, CLAD incidence or survival at 1 and 3 years after transplant (DBD: 87.1% and 78.1%; cDCD: 89.7% and 89.7%; uDCD: 85.7% and 85.7% respectively; P = 0.42). Short- and mid-term outcomes are comparable between the three types of donors. These findings may encourage and reinforce all types of donation after circulatory death programmes as a valid and growing source of suitable organs for transplantation.
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Affiliation(s)
- Jose Luis Campo-Cañaveral de la Cruz
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid., Madrid, Spain
| | - Silvana Crowley Carrasco
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid., Madrid, Spain
| | - Shin Tanaka
- Department of General Thoracic Surgery/Organ Transplant Center, Okayama University Hospital, Okayama, Japan
| | - Alejandra Romero Román
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid., Madrid, Spain
| | - Lucas Hoyos Mejía
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid., Madrid, Spain
| | - Mariana Gil Barturen
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid., Madrid, Spain
| | - Álvaro Sánchez Calle
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid., Madrid, Spain
| | - Christian García Fadul
- Pneumology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Myriam Aguilar Pérez
- Pneumology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Marina Pérez Redondo
- Intensive Care Unit, Transplant Coordinator, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Jose Manuel Naranjo Gómez
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid., Madrid, Spain
| | - Ana Royuela
- Biostatistics Unit, Puerta de Hierro Biomedical Research Institute (IDIPHISA), CIBERESP, Madrid, Spain
| | - Mar Córdoba Peláez
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid., Madrid, Spain
| | - Andrés Varela de Ugarte
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid., Madrid, Spain
| | - David Gómez de Antonio
- Thoracic Surgery and Lung Transplantation Department, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid., Madrid, Spain
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Tanaka S, Campo-Cañaveral de la Cruz JL, Barturen MG, Carrasco SC, Román AR, León MTSD, Mejía LH, Gómez JMN, Peláez MC, Calle ÁS, Redondo MP, Fadul CG, Ugarte AVD, de-Antonio DG. Post-transplant outcomes of standard and extended criteria donation after circulatory death donor lungs categorized by donation after brain death lung criteria. Eur J Cardiothorac Surg 2021; 60:590-597. [PMID: 33693567 DOI: 10.1093/ejcts/ezab121] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 02/02/2021] [Accepted: 02/08/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Most transplant centres use donation after brain death (DBD) criteria to assess the quality of controlled donation after circulatory death (cDCD) lungs. However, research on the relationship between DBD extended criteria and cDCD lung transplantation outcomes is limited. We investigated the outcomes of using DBD extended criteria donor organs in cDCD lung transplantation, compared to the standard criteria cDCD lung transplantation. METHODS A retrospective chart review of consecutive cDCD lung referrals to Hospital Universitario Puerta de Hierro-Majadahonda from June 2013 to December 2019 was undertaken. Donors were divided into standard and extended criteria groups. Early outcomes after lung transplant were compared between these groups using the Kaplan-Meier method and log-rank test. RESULTS Thirty out of 91 cDCD donor lung offers were accepted for transplantation, of which 11 were from standard criteria donors and 19 were extended criteria donors. The baseline characteristics of the 2 recipient groups were similar. There were no differences in the rates of grade 3 primary graft dysfunction at 72 h after lung transplantation (21% vs 18%), duration of mechanical ventilation (48 h vs 36 h), total intensive care unit stay (10 days vs 7 days) and 1-year survival (89% vs 90%). CONCLUSIONS Carefully selecting cDCD lungs from outside the standard acceptability criteria may expand the existing donor pool with no detrimental effects on lung transplantation outcomes.
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Affiliation(s)
- Shin Tanaka
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | | | - Mariana Gil Barturen
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Silvana Crowley Carrasco
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Alejandra Romero Román
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - María Trujillo Sánchez de León
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Lucas Hoyos Mejía
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Jose Manuel Naranjo Gómez
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Mar Córdoba Peláez
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Álvaro Sánchez Calle
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Marina Pérez Redondo
- Intensive Care Unit, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | | | - Andrés Varela de Ugarte
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - David Gómez- de-Antonio
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
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Gómez de Antonio D, Crowley Carrasco S, Romero Román A, Royuela A, Sánchez Calle Á, Obiols Fornell C, Call Caja S, Embún R, Royo Í, Recuero JL, Cabañero A, Moreno N, Bolufer S, Congregado M, Jimenez MF, Aguinagalde B, Amor-Alonso S, Arrarás MJ, Blanco Orozco AI, Boada M, Cal I, Cilleruelo Ramos Á, Fernández-Martín E, García-Barajas S, García-Jiménez MD, García-Prim JM, Garcia-Salcedo JA, Gelbenzu-Zazpe JJ, Giraldo-Ospina CF, Gómez Hernández MT, Hernández J, Illana Wolf JD, Jáuregui Abularach A, Jiménez U, López Sanz I, Martínez-Hernández NJ, Martínez-Téllez E, Milla Collado L, Mongil Poce R, Moradiellos-Díez FJ, Moreno-Basalobre R, Moreno Merino SB, Quero-Valenzuela F, Ramírez-Gil ME, Ramos-Izquierdo R, Rivo E, Rodríguez-Fuster A, Rojo-Marcos R, Sanchez-Lorente D, Moreno LS, Simón C, Trujillo-Reyes JC, López García C, Fibla Alfara JJ, Sesma Romero J, Hernando Trancho F. Surgical Risk Following Anatomic Lung Resection in Thoracic Surgery: A Prediction Model Derived from a Spanish Multicenter Database. Arch Bronconeumol 2021; 58:398-405. [PMID: 33752924 DOI: 10.1016/j.arbres.2021.01.037] [Citation(s) in RCA: 1] [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: 12/08/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 11/02/2022]
Abstract
INTRODUCTION The aim of this study was to develop a surgical risk prediction model in patients undergoing anatomic lung resections from the registry of the Spanish Video-Assisted Thoracic Surgery Group (GEVATS). METHODS Data were collected from 3,533 patients undergoing anatomic lung resection for any diagnosis between December 20, 2016 and March 20, 2018. We defined a combined outcome variable: death or Clavien Dindo grade IV complication at 90 days after surgery. Univariate and multivariate analyses were performed by logistic regression. Internal validation of the model was performed using resampling techniques. RESULTS The incidence of the outcome variable was 4.29% (95% CI 3.6-4.9). The variables remaining in the final logistic model were: age, sex, previous lung cancer resection, dyspnea (mMRC), right pneumonectomy, and ppo DLCO. The performance parameters of the model adjusted by resampling were: C-statistic 0.712 (95% CI 0.648-0.750), Brier score 0.042 and bootstrap shrinkage 0.854. CONCLUSIONS The risk prediction model obtained from the GEVATS database is a simple, valid, and reliable model that is a useful tool for establishing the risk of a patient undergoing anatomic lung resection.
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Affiliation(s)
- David Gómez de Antonio
- Servicio de Cirugía Torácica, Hospital Universitario Puerta de Hierro Majadahonda. Madrid, España.
| | - Silvana Crowley Carrasco
- Servicio de Cirugía Torácica, Hospital Universitario Puerta de Hierro Majadahonda. Madrid, España
| | - Alejandra Romero Román
- Servicio de Cirugía Torácica, Hospital Universitario Puerta de Hierro Majadahonda. Madrid, España
| | - Ana Royuela
- Unidad de Bioestadística, Instituto de Investigación Biomédica Puerta de Hierro (IDIPHISA); CIBERESP. Madrid, España
| | - Álvaro Sánchez Calle
- Servicio de Cirugía Torácica, Hospital Universitario Puerta de Hierro Majadahonda. Madrid, España
| | - Carme Obiols Fornell
- Servicio de Cirugía Torácica, Hospital Universitari Mútua Terrassa, Universidad de Barcelona, Terrassa, Barcelona, España
| | - Sergi Call Caja
- Servicio de Cirugía Torácica, Hospital Universitari Mútua Terrassa, Universidad de Barcelona, Terrassa, Barcelona, España
| | - Raúl Embún
- Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, España
| | - Íñigo Royo
- Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, España
| | - José Luis Recuero
- Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, España
| | - Alberto Cabañero
- Servicio de Cirugía Torácica, Hospital Universitario Ramón y Cajal. Madrid, España
| | - Nicolás Moreno
- Servicio de Cirugía Torácica, Hospital Universitario Ramón y Cajal. Madrid, España
| | - Sergio Bolufer
- Servicio de Cirugía Torácica, Hospital General Universitario de Alicante, Alicante, España
| | - Miguel Congregado
- Servicio de Cirugía Torácica, Hospital Universitario Virgen Macarena, Sevilla, España
| | - Marcelo F Jimenez
- Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Universidad de Salamanca, IBSAL, Salamanca, España
| | - Borja Aguinagalde
- Servicio de Cirugía Torácica, Hospital Universitario de Donostia, San Sebastián-Donostia, España
| | - Sergio Amor-Alonso
- Servicio de Cirugía Torácica, Hospital Universitario Quironsalud Madrid, Madrid, España
| | - Miguel Jesús Arrarás
- Servicio de Cirugía Torácica, Fundación Instituto Valenciano de Oncología, Valencia, España
| | | | - Marc Boada
- Servicio de Cirugía Torácica, Hospital Clinic de Barcelona, Instituto Respiratorio, Universidad de Barcelona, Barcelona, España
| | - Isabel Cal
- Servicio de Cirugía Torácica, Hospital Universitario La Princesa, Madrid, España
| | | | | | | | | | - Jose María García-Prim
- Servicio de Cirugía Torácica, Hospital Universitario Santiago de Compostela , Santiago de Compostela, España
| | | | | | | | - María Teresa Gómez Hernández
- Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Universidad de Salamanca, IBSAL, Salamanca, España
| | - Jorge Hernández
- Servicio de Cirugía Torácica, Hospital Universitario Sagrat Cor, Barcelona, España
| | | | | | - Unai Jiménez
- Servicio de Cirugía Torácica, Hospital Universitario Cruces, Bilbao, España
| | - Iker López Sanz
- Servicio de Cirugía Torácica, Hospital Universitario de Donostia, San Sebastián-Donostia, España
| | | | - Elisabeth Martínez-Téllez
- Servicio de Cirugía Torácica, Hospital Santa Creu y Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España
| | | | - Roberto Mongil Poce
- Servicio de Cirugía Torácica, Hospital Regional Universitario, Málaga, España
| | | | | | | | | | | | - Ricard Ramos-Izquierdo
- Servicio de Cirugía Torácica, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España
| | - Eduardo Rivo
- Servicio de Cirugía Torácica, Hospital Universitario Santiago de Compostela , Santiago de Compostela, España
| | - Alberto Rodríguez-Fuster
- Servicio de Cirugía Torácica, Hospital del Mar, IMIM (Instituto de Investigación Médica Hospital del Mar), Barcelona, España
| | - Rafael Rojo-Marcos
- Servicio de Cirugía Torácica, Hospital Universitario Cruces, Bilbao, España
| | - David Sanchez-Lorente
- Servicio de Cirugía Torácica, Hospital Clinic de Barcelona, Instituto Respiratorio, Universidad de Barcelona, Barcelona, España
| | - Laura Sánchez Moreno
- Servicio de Cirugía Torácica, Hospital Universitario Marqués de Valdecilla, Santader, España
| | - Carlos Simón
- Servicio de Cirugía Torácica, Hospital Universitario Gregorio Marañón, Madrid, España
| | - Juan Carlos Trujillo-Reyes
- Servicio de Cirugía Torácica, Hospital Santa Creu y Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España
| | | | | | - Julio Sesma Romero
- Servicio de Cirugía Torácica, Hospital General Universitario de Alicante, Alicante, España
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Tanaka S, Luis Campo-Cañaveral de la Cruz J, Crowley Carrasco S, Romero Román A, Hoyos Mejía L, Manuel NaranjoGómez J, Córdoba Peláez M, Sánchez Calle Á, Gil Barturen M, Pérez Redondo M, García Fadul C, Varela de Ugarte A, Gómez-de-Antonio D. Effect on the donor lungs of using abdominal normothermic regional perfusion in controlled donation after circulatory death. Eur J Cardiothorac Surg 2020; 59:ezaa398. [PMID: 33225359 DOI: 10.1093/ejcts/ezaa398] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/21/2020] [Accepted: 08/22/2020] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVES Controlled donation after circulatory death (cDCD) donors are becoming a common source of organs for transplantation globally. However, the graft survival rate of cDCD abdominal organs is inferior to that of organs from brain-dead donors. The rapid retrieval (RR) technique is used by most donor organ procurement teams. The abdominal normothermic regional perfusion (A-NRP) technique has been implemented to minimize warm ischaemic damage to the abdominal organs. However, there is limited information on the effect of A-NRP on the quality of the donor lungs. This study aimed to compare lung transplantation outcomes using lungs procured from cDCD donors using the A-NRP and abdominal RR techniques. METHODS A single-centre retrospective analysis of consecutive transplant recipients of cDCD lungs from June 2013 to December 2019 was performed. The recipients were divided into 2 cohorts according to the abdominal procurement technique used. The recipient and donor characteristics (age, sex, cause of brain injury, warm ischaemic time, diagnosis, lung allocation score and other factors), incidence of primary graft dysfunction and early survival were monitored. RESULTS Twenty-eight consecutive lung transplantation recipients were identified (median age 59 years; 61% male); 14 recipients received lungs using the A-NRP and 14 using abdominal RR for abdominal organ retrieval. There were no significant differences in the baseline characteristics, primary graft dysfunction (P = 0.70), hospital mortality (P = 1.0) and 1-year survival rate (P = 1.0) between the 2 groups. CONCLUSIONS No difference was observed in lung transplantation outcomes irrespective of the abdominal organ procurement technique used (A-NRP or abdominal RR).
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Affiliation(s)
- Shin Tanaka
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | | | - Silvana Crowley Carrasco
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Alejandra Romero Román
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Lucas Hoyos Mejía
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Jose Manuel NaranjoGómez
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Mar Córdoba Peláez
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Álvaro Sánchez Calle
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Mariana Gil Barturen
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Marina Pérez Redondo
- Intensive Care Unit, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Christian García Fadul
- Department of Pneumology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Andrés Varela de Ugarte
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - David Gómez-de-Antonio
- Department of Thoracic Surgery and Lung Transplantation, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
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14
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Embun R, Royo-Crespo I, Recuero Díaz JL, Bolufer S, Call S, Congregado M, Gómez-de Antonio D, Jimenez MF, Moreno-Mata N, Aguinagalde B, Amor-Alonso S, Arrarás MJ, Blanco Orozco AI, Boada M, Cabañero Sánchez A, Cal Vázquez I, Cilleruelo Ramos Á, Crowley Carrasco S, Fernández-Martín E, García-Barajas S, García-Jiménez MD, García-Prim JM, Garcia-Salcedo JA, Gelbenzu-Zazpe JJ, Giraldo-Ospina CF, Gómez Hernández MT, Hernández J, Wolf JDI, Jauregui Abularach A, Jiménez U, López Sanz I, Martínez-Hernández NJ, Martínez-Téllez E, Milla Collado L, Mongil Poce R, Moradiellos-Díez FJ, Moreno-Balsalobre R, Moreno Merino SB, Obiols C, Quero-Valenzuela F, Ramírez-Gil ME, Ramos-Izquierdo R, Rivo E, Rodríguez-Fuster A, Rojo-Marcos R, Sanchez-Lorente D, Sanchez Moreno L, Simón C, Trujillo-Reyes JC, Hernando Trancho F. Spanish Video-Assisted Thoracic Surgery Group: Method, Auditing, and Initial Results From a National Prospective Cohort of Patients Receiving Anatomical Lung Resections. Arch Bronconeumol 2020; 56:718-724. [PMID: 35579917 DOI: 10.1016/j.arbr.2020.01.009] [Citation(s) in RCA: 1] [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: 10/31/2019] [Accepted: 01/05/2020] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Our study sought to know the current implementation of video-assisted thoracoscopic surgery (VATS) for anatomical lung resections in Spain. We present our initial results and describe the auditing systems developed by the Spanish VATS Group (GEVATS). METHODS We conducted a prospective multicentre cohort study that included patients receiving anatomical lung resections between 12/20/2016 and 03/20/2018. The main quality controls consisted of determining the recruitment rate of each centre and the accuracy of the perioperative data collected based on six key variables. The implications of a low recruitment rate were analysed for "90-day mortality" and "Grade IIIb-V complications". RESULTS The series was composed of 3533 cases (1917 VATS; 54.3%) across 33 departments. The centres' median recruitment rate was 99% (25-75th:76-100%), with an overall recruitment rate of 83% and a data accuracy of 98%. We were unable to demonstrate a significant association between the recruitment rate and the risk of morbidity/mortality, but a trend was found in the unadjusted analysis for those centres with recruitment rates lower than 80% (centres with 95-100% rates as reference): grade IIIb-V OR=0.61 (p=0.081), 90-day mortality OR=0.46 (p=0.051). CONCLUSIONS More than half of the anatomical lung resections in Spain are performed via VATS. According to our results, the centre's recruitment rate and its potential implications due to selection bias, should deserve further attention by the main voluntary multicentre studies of our speciality. The high representativeness as well as the reliability of the GEVATS data constitute a fundamental point of departure for this nationwide cohort.
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Affiliation(s)
- Raul Embun
- Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, Spain.
| | - Iñigo Royo-Crespo
- Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, Spain
| | - José Luis Recuero Díaz
- Servicio de Cirugía Torácica, Hospital Universitario Miguel Servet y Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, Spain
| | - Sergio Bolufer
- Servicio de Cirugía Torácica, Hospital General Universitario de Alicante, Alicante, Spain
| | - Sergi Call
- Servicio de Cirugía Torácica, Hospital Universitari Mútua Terrasa, Universidad de Barcelona, Terrasa, Barcelona, Spain
| | - Miguel Congregado
- Servicio de Cirugía Torácica, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - David Gómez-de Antonio
- Servicio de Cirugía Torácica, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Marcelo F Jimenez
- Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Universidad de Salamanca, IBSAL, Salamanca, Spain
| | - Nicolas Moreno-Mata
- Servicio de Cirugía Torácica, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Borja Aguinagalde
- Servicio de Cirugía Torácica, Hospital Universitario de Donostia, San Sebastián-Donostia, Spain
| | - Sergio Amor-Alonso
- Servicio de Cirugía Torácica, Hospital Universitario Quironsalud Madrid, Madrid, Spain
| | - Miguel Jesús Arrarás
- Servicio de Cirugía Torácica, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | | | - Marc Boada
- Servicio de Cirugía Torácica, Hospital Clinic de Barcelona, Instituto Respiratorio, Universidad de Barcelona, Barcelona, Spain
| | | | - Isabel Cal Vázquez
- Servicio de Cirugía Torácica, Hospital Universitario La Princesa, Madrid, Spain
| | | | - Silvana Crowley Carrasco
- Servicio de Cirugía Torácica, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | | | | | | | - Jose María García-Prim
- Servicio de Cirugía Torácica, Hospital Universitario Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | | | - María Teresa Gómez Hernández
- Servicio de Cirugía Torácica, Hospital Universitario de Salamanca, Universidad de Salamanca, IBSAL, Salamanca, Spain
| | - Jorge Hernández
- Servicio de Cirugía Torácica, Hospital Universitario Sagrat Cor, Barcelona, Spain
| | | | | | - Unai Jiménez
- Servicio de Cirugía Torácica, Hospital Universitario Cruces, Bilbao, Spain
| | - Iker López Sanz
- Servicio de Cirugía Torácica, Hospital Universitario de Donostia, San Sebastián-Donostia, Spain
| | | | - Elisabeth Martínez-Téllez
- Servicio de Cirugía Torácica, Hospital Santa Creu y Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain
| | | | - Roberto Mongil Poce
- Servicio de Cirugía Torácica, Hospital Regional Universitario, Málaga, Spain
| | | | | | | | - Carme Obiols
- Servicio de Cirugía Torácica, Hospital Universitari Mútua Terrasa, Universidad de Barcelona, Terrasa, Barcelona, Spain
| | | | | | - Ricard Ramos-Izquierdo
- Servicio de Cirugía Torácica, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Eduardo Rivo
- Servicio de Cirugía Torácica, Hospital Universitario Santiago de Compostela, Santiago de Compostela, Spain
| | - Alberto Rodríguez-Fuster
- Servicio de Cirugía Torácica, Hospital del Mar, Barcelona, Spain; IMIM (Instituto de Investigación Médica Hospital del Mar), Barcelona, Spain
| | - Rafael Rojo-Marcos
- Servicio de Cirugía Torácica, Hospital Universitario Cruces, Bilbao, Spain
| | - David Sanchez-Lorente
- Servicio de Cirugía Torácica, Hospital Clinic de Barcelona, Instituto Respiratorio, Universidad de Barcelona, Barcelona, Spain
| | - Laura Sanchez Moreno
- Servicio de Cirugía Torácica, Hospital Universitario Marqués de Valdecilla, Santader, Spain
| | - Carlos Simón
- Servicio de Cirugía Torácica, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Juan Carlos Trujillo-Reyes
- Servicio de Cirugía Torácica, Hospital Santa Creu y Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain
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Embun R, Royo-Crespo I, Recuero Díaz JL, Bolufer S, Call S, Congregado M, Gómez-de Antonio D, Jimenez MF, Moreno-Mata N, Aguinagalde B, Amor-Alonso S, Arrarás MJ, Blanco Orozco AI, Boada M, Cabañero Sánchez A, Cal Vázquez I, Cilleruelo Ramos Á, Crowley Carrasco S, Fernández-Martín E, García-Barajas S, García-Jiménez MD, García-Prim JM, Garcia-Salcedo JA, Gelbenzu-Zazpe JJ, Giraldo-Ospina CF, Gómez Hernández MT, Hernández J, Wolf JDI, Jauregui Abularach A, Jiménez U, López Sanz I, Martínez-Hernández NJ, Martínez-Téllez E, Milla Collado L, Mongil Poce R, Moradiellos-Díez FJ, Moreno-Balsalobre R, Moreno Merino SB, Obiols C, Quero-Valenzuela F, Ramírez-Gil ME, Ramos-Izquierdo R, Rivo E, Rodríguez-Fuster A, Rojo-Marcos R, Sanchez-Lorente D, Sanchez Moreno L, Simón C, Trujillo-Reyes JC, Hernando Trancho F. Spanish Video-Assisted Thoracic Surgery Group: Method, Auditing, and Initial Results From a National Prospective Cohort of Patients Receiving Anatomical Lung Resections. Arch Bronconeumol 2020. [DOI: 10.1016/j.arbres.2020.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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