November 18, 2011

The Impact of Pretransplant Mechanical Ventilation on Short- and Long-Term Survival After Lung Transplantation


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Mechanical ventilation remains a strong relative contraindication to lung transplant in most centres.  Patients requiring ongoing mechanical ventilation prior to lung transplant are likely to receive a high Lung Allocation Score to reflect the higher urgency and worse expected outcome of lung transplant.  Analyzing adult lung transplants in the United States from 2005-2010 (LAS era) requiring pretransplant mechanical ventilation and comparing to nonventilated, propensity score-matched referents, this study demonstrated overall decreased survival after lung transplantation in the mechanically ventilated group.  However, this decrease in survival appeared to be limited to the first 6 months post transplant.  Pre-transplant diagnosis in the mechanically ventilated group also had implications, with COPD not associated with decreased survival at 6 months, and both pulmonary fibrosis and cystic fibrosis groups associated with poorer 6-month survival.

Lung Transplantation

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