Abstract: Slide Presentations |


Saba Lodhi, MD*; Adriano R. Tonelli, MD; Olufemi A. Akindipe, MD; Sebastian Fernandez-Bussy, MD; Robin D. Carrie, ARNP-C; Edward D. Staples, MD; Maher A. Baz, MD
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University of Florida, Gainesville, FL


Chest. 2009;136(4_MeetingAbstracts):17S. doi:10.1378/chest.136.4_MeetingAbstracts.17S-g
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PURPOSE:  To identify predictors for the use of cardiopulmonary bypass (CPB) in patients (pts) undergoing lung transplantation.

METHODS:  We retrospectively reviewed the charts of pts, who underwent lung transplantation at the University of Florida from 1/2003 to 12/2008, to identify preoperative predictors for the use of CPB. Re-transplantations and pts with idiopathic pulmonary artery hypertension were excluded from this analysis.

RESULTS:  A total of 283 pts completed lung transplant evaluation and 96 pts were transplanted. None of the pts who underwent unilateral transplantation (n=41) required the use of CPB. Of the pts that underwent bilateral transplantation (n=55), 35 patients required CPB. In bilateral lung transplanted pts, factors found to be associated with the use of CPB in univariate analysis were: the presence of restrictive versus obstructive disease (OR 6.5 [95%CI: 1.9–22.2), need to use >4 l/m of O2 (OR 9.5 [95% CI: 1.1–81], higher systolic pulmonary arterial pressure (sPAP) (OR 1.11 [95% CI: 1.03–1.16]), lower cardiac output (OR 0.46 [95% CI: 0.25–0.83]), higher pulmonary vascular resistance (PVR)(OR 2.1 [95% CI:1.28–3.4]) and presence of DLCO <35% of predicted (OR 7.8 [95% CI: 1.7–34.8]. In multivariate analysis only DLCO <35% was significantly associated with the use of CPB (OR 15.1 [95% CI: 1.3–172.8]). Using Classification and Regression Tree (CART) analysis, the variables that best predicted the use of CPB were PVR >3 Wood Units (OR 20.8 [95%CI: 4.5–95.9]), sPAP >50mmHg (OR 15.3 [95%CI 3–77]) and DLCO<35% (OR 7.8 [95%CI 1.7–34.8]).

CONCLUSION:  In the population study, the use of CPB is limited to pts undergoing bilateral lung transplantation. A PVR above 3 Wood Units, sPAP >50 mmHg, DLCO <35% and the presence of restrictive versus obstructive lung disease are associated with the need of using cardiopulmonary bypass in patients undergoing bilateral lung transplantation.

CLINICAL IMPLICATIONS:  The presence of restrictive lung disease, PVR above 3 Wood Units, sPAP >50 mmHg and DLCO <35% serve as reliable preoperative predictors of the need for CPB in lung transplantation.

DISCLOSURE:  Saba Lodhi, No Financial Disclosure Information; No Product/Research Disclosure Information

Monday, November 2, 2009

2:30 PM - 3:30 PM




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