학술논문

Objective Estimates Improve Risk Stratification for Primary Graft Dysfunction after Lung Transplantation
Document Type
article
Source
American Journal of Transplantation. 15(8)
Subject
Patient Safety
Prevention
Lung
Rare Diseases
Organ Transplantation
Clinical Research
Transplantation
Respiratory
Adult
Female
Humans
Lung Transplantation
Male
Primary Graft Dysfunction
Risk Factors
clinical research / practice
lung (allograft) function / dysfunction
lung failure / injury
lung transplantation / pulmonology
Medical and Health Sciences
Surgery
Language
Abstract
Primary graft dysfunction (PGD) is a major cause of early mortality after lung transplant. We aimed to define objective estimates of PGD risk based on readily available clinical variables, using a prospective study of 11 centers in the Lung Transplant Outcomes Group (LTOG). Derivation included 1255 subjects from 2002 to 2010; with separate validation in 382 subjects accrued from 2011 to 2012. We used logistic regression to identify predictors of grade 3 PGD at 48/72 h, and decision curve methods to assess impact on clinical decisions. 211/1255 subjects in the derivation and 56/382 subjects in the validation developed PGD. We developed three prediction models, where low-risk recipients had a normal BMI (18.5-25 kg/m(2) ), chronic obstructive pulmonary disease/cystic fibrosis, and absent or mild pulmonary hypertension (mPAP