0
Articles |

Primary Graft Failure Following Lung Transplantation

Jason D. Christie; Joseph E. Bavaria; Harold I. Palevsky; Leslie Litzky; Nancy P. Blumenthal; Larry R. Kaiser; Robert M. Kotloff
Author and Funding Information

Affiliations: From the Pulmonary and Critical Care Division, Department of Medicine, University of Pennsylvania Medical Center, Philadelphia,  From the Division of General Thoracic Surgery, Department of Surgery, University of Pennsylvania Medical Center, Philadelphia,  From the Division of General Thoracic Surgery, and the Department of Pathology, University of Pennsylvania Medical Center, Philadelphia

Affiliations: From the Pulmonary and Critical Care Division, Department of Medicine, University of Pennsylvania Medical Center, Philadelphia,  From the Division of General Thoracic Surgery, Department of Surgery, University of Pennsylvania Medical Center, Philadelphia,  From the Division of General Thoracic Surgery, and the Department of Pathology, University of Pennsylvania Medical Center, Philadelphia

Affiliations: From the Pulmonary and Critical Care Division, Department of Medicine, University of Pennsylvania Medical Center, Philadelphia,  From the Division of General Thoracic Surgery, Department of Surgery, University of Pennsylvania Medical Center, Philadelphia,  From the Division of General Thoracic Surgery, and the Department of Pathology, University of Pennsylvania Medical Center, Philadelphia


1998 by the American College of Chest Physicians


Chest. 1998;114(1):51-60. doi:10.1378/chest.114.1.51
Text Size: A A A
Published online

Abstract

Study objectives: To determine the incidence of primary graft failure (PGF) following lung transplantation, assess possible risk factors, and characterize its effect on outcomes.

Methods: Retrospective review of 100 consecutive patients undergoing lung transplantation at the University of Pennsylvania Medical Center. Fifteen patients meeting diagnostic criteria for PGF (PGF+ group) were compared with 85 patients without this complication (PGF− group).

Results: The incidence of PGF was 15%. There was no significant difference in age, sex, underlying pulmonary disease, preoperative pulmonary artery systolic pressure, type of transplant, allograft ischemic times, use of cardiopulmonary bypass, or use of postoperative prostaglandin E1 infusion between the PGF+ and PGF− groups. Induction therapy with antilymphocyte globulin was used less frequently in the PGF+ group (p<0.005). Duration of mechanical ventilatory support was 36±43 days vs 4±6 days for the PGF+ and PGF− groups, respectively (p<0.0001). Hospital stay was significantly longer in the PGF+ group, averaging 75±105 days, compared with 27±38 days in the PGF group (p<0.005). One-year actuarial survival for the PGF+ group was only 40% compared with 69% for the PGF− group (p<0.005). Five of the six PGF+ survivors were ambulatory by 1 year; three were completely independent while two continued to require assistance with activities of daily living. Six-minute walk test distance among the ambulatory patients averaged 883±463 feet (range, 200 to 1,223 feet) compared with 1513±424 feet for the PGF− group (p<0.005). Among the subset of survivors who underwent single lung transplantation for COPD, the mean percent predicted FEV1 at 1 year was 43% for the PGF+ group and 55% for the PGF− groups, but this difference was not statistically significant.

Conclusions: PGF is a devastating postoperative complication, occuring in 15% of patients in the current series, and it is associated with a high mortality rate, lengthy hospitalization, and protracted and often compromised recovery among survivors.


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543