Original Articles
Lung Transplantation in Cystic Fibrosis: Perioperative Mortality
J. Padilla
, V. Calvo, C. Jordá, J. Escrivá, J. Cerón, J.C. Peñalver, A. García-Zarza, J. Pastor, E. Blasco
Corresponding author
jpadilla@comv.es
Correspondence: Dr. J. Padilla. Servicio de Cirugía Torácica. Hospital Universitario La Fe. Avda. de Campanar, 21. 46009 Valencia. España
Correspondence: Dr. J. Padilla. Servicio de Cirugía Torácica. Hospital Universitario La Fe. Avda. de Campanar, 21. 46009 Valencia. España
Servicio de Cirugía Torácica, Hospital Universitario La Fe, Valencia, Spain
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Peñalver, J. Padilla, C. Jordá, J. Escrivá, J. Cerón, V. Calvo, A. García, J. Pastor, E. Blasco" "autores" => array:9 [ 0 => array:3 [ "preGrado" => "Dr." "nombre" => "J.C." "apellidos" => "Peñalver" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Padilla" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Jordá" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Escrivá" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Cerón" ] 5 => array:2 [ "nombre" => "V." "apellidos" => "Calvo" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "García" ] 7 => array:2 [ "nombre" => "J." "apellidos" => "Pastor" ] 8 => array:2 [ "nombre" => "E." "apellidos" => "Blasco" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157921290660267X?idApp=UINPBA00003Z" "url" => "/15792129/0000004100000009/v1_201305150225/S157921290660267X/v1_201305150225/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>" "titulo" => "Lung Transplantation in Cystic Fibrosis: Perioperative Mortality" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "489" "paginaFinal" => "492" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Padilla, V. Calvo, C. Jordá, J. Escrivá, J. Cerón, J.C. Peñalver, A. García-Zarza, J. Pastor, E. Blasco" "autores" => array:9 [ 0 => array:5 [ "preGrado" => "Dr." "nombre" => "J." "apellidos" => "Padilla" "email" => array:1 [ 0 => "jpadilla@comv.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "V." "apellidos" => "Calvo" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Jordá" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Escrivá" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Cerón" ] 5 => array:2 [ "nombre" => "J.C." "apellidos" => "Peñalver" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "García-Zarza" ] 7 => array:2 [ "nombre" => "J." "apellidos" => "Pastor" ] 8 => array:2 [ "nombre" => "E." "apellidos" => "Blasco" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Cirugía Torácica, Hospital Universitario La Fe, Valencia, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. J. Padilla. Servicio de Cirugía Torácica. Hospital Universitario La Fe. Avda. de Campanar, 21. 46009 Valencia. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-09-18" "fechaAceptado" => "2005-01-18" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec154148" "palabras" => array:3 [ 0 => "Cystic fibrosis" 1 => "Lung transplant" 2 => "Perioperative mortality" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154149" "palabras" => array:3 [ 0 => "Fibrosis quística" 1 => "Trasplante pulmonary" 2 => "Mortalidad perioperatoria" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To determine the incidence and causes of perioperative mortality following lung transplant for cystic fibrosis.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">We analyzed the cases of 57 patients. Fifty-five patients received double lung transplants, 1 received a heart-double lung transplant, and 1 received a combined double lung and liver transplant. Information related to the organ donor, recipient, lung graft, and early postoperative period was gathered. Perioperative mortality was defined as death resulting from anesthesia or surgery regardless of how many days had passed. The Kaplan-Meier method was used to analyze survival. A Cox logistic regression model was used to determine variables affecting mortality.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Survival was 83.7% at 1 year after transplantation, 77.3% at 2 years, and 66.9% at 5 years. Five (8.7%) patients died as a result of anesthesia or surgery. A ratio of PaO<span class="elsevierStyleInf">2</span> to inspired oxygen fraction (FiO<span class="elsevierStyleInf">2</span>) less than 200 mm Hg in the early postoperative period was observed in 8 (14%) patients. Primary graft failure occurred in 4 patients, due to pneumonia in 2 and to biventricular dysfunction in 2. Three of those patients died. Two patients with PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> greater than 200 mm Hg died after surgery, 1 from septic shock due to <span class="elsevierStyleItalic">Pseudomonas cepacia</span> and the other from massive cerebral infarction.</p><p class="elsevierStyleSimplePara elsevierViewall">PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> upon admission to the recovery care unit was the only variable significantly associated with perioperative mortality in the logistic regression model (<span class="elsevierStyleItalic">P</span> = .0034).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The only factor significantly related to perioperative mortality in patients receiving transplants for cystic fibrosis was PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> upon admission to the recovery unit.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Conocer la incidencia y las causas de mortalidad perioperatoria en el trasplante pulmonar por fibrosis quística.</p> <span class="elsevierStyleSectionTitle">Pacientesy métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha analizado a 57 pacientes. Se realizaron 55 trasplantes bipulmonares, uno cardiobipulmonar y uno hepatobipulmonar. Se recogieron una serie de datos del donante, del receptor, del injerto pulmonar y del postoperatorio inmediato. Se definió la mortalidad perioperatoria cuando el fallecimiento aconteció como consecuencia del acto anestésico-quirúrgico, independientemente de los días transcurridos. Para determinar qué variables la condicionaron se utilizó el modelo de regresión logística de Cox. La supervivencia se calculó mediante el método de Kaplan-Meier.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La supervivencia fue del 83,7% al año del trasplante, del 77,3% a los 2 años y del 66,9% a los 5 años. Cinco pacientes (8,7%) fallecieron en el perioperatorio. En 8 (14%) se objetivó un cociente de presión arterial de oxígeno (PaO<span class="elsevierStyleInf">2</span>)/fracción inspiratoria de oxígeno (FiO<span class="elsevierStyleInf">2</span>) inspirado < 200 mmHg en el perioperatorio inmediato y 4 se catalogaron como fracaso primario del injerto, 2 por una neumonía y 2 por disfunción biventricular; 3 de estos pacientes fallecieron. Dos pacientes con un cociente PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> >200 mmHg fallecieron en el perioperatorio, uno por un shock séptico por <span class="elsevierStyleItalic">Pseudomonas cepacia</span> y otro por un infarto cerebral masivo.</p><p class="elsevierStyleSimplePara elsevierViewall">Mediante el análisis de regresión logística, el cociente PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> al ingresar en la unidad de reanimación fue la única variable que condicionó significativamente la mortalidad perioperatoria (p = 0,0034).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">El cociente PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> al ingresar en la unidad de reanimación fue la única variable que condicionó significativamente la mortalidad perioperatoria en los pacientes trasplantados por fibrosis quística.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:25 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Cystic Fibrosis Foundation" ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:1 [ "link" => "Available at: http://www.cff.org" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of diagnosis on survival benefit of lung transplantation for end-stage lung disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "JD Hosenpud" 1 => "LE Bennett" 2 => "BM Keck" 3 => "EB Edwards" 4 => "RJ Novick" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(97)06405-2" "Revista" => array:6 [ "tituloSerie" => 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 2 | 4 |
| 2024 October | 30 | 20 | 50 |
| 2024 September | 29 | 12 | 41 |
| 2024 August | 42 | 40 | 82 |
| 2024 July | 25 | 18 | 43 |
| 2024 June | 27 | 23 | 50 |
| 2024 May | 39 | 29 | 68 |
| 2024 April | 17 | 19 | 36 |
| 2024 March | 15 | 11 | 26 |
| 2024 February | 19 | 23 | 42 |
| 2023 March | 2 | 2 | 4 |
| 2023 February | 16 | 20 | 36 |
| 2023 January | 14 | 35 | 49 |
| 2022 December | 21 | 32 | 53 |
| 2022 November | 18 | 19 | 37 |
| 2022 October | 21 | 28 | 49 |
| 2022 September | 17 | 27 | 44 |
| 2022 August | 24 | 38 | 62 |
| 2022 July | 19 | 34 | 53 |
| 2022 June | 17 | 34 | 51 |
| 2022 May | 17 | 33 | 50 |
| 2022 April | 26 | 37 | 63 |
| 2022 March | 18 | 34 | 52 |
| 2022 February | 15 | 22 | 37 |
| 2022 January | 14 | 30 | 44 |
| 2021 December | 15 | 43 | 58 |
| 2021 November | 22 | 49 | 71 |
| 2021 October | 17 | 46 | 63 |
| 2021 September | 11 | 40 | 51 |
| 2021 August | 20 | 27 | 47 |
| 2021 July | 24 | 31 | 55 |
| 2021 June | 11 | 28 | 39 |
| 2021 May | 40 | 22 | 62 |
| 2021 April | 52 | 46 | 98 |
| 2021 March | 27 | 16 | 43 |
| 2021 February | 11 | 23 | 34 |
| 2021 January | 14 | 9 | 23 |
| 2020 December | 10 | 10 | 20 |
| 2020 November | 10 | 7 | 17 |
| 2020 October | 7 | 5 | 12 |
| 2020 September | 2 | 7 | 9 |
| 2020 August | 11 | 9 | 20 |
| 2020 July | 10 | 17 | 27 |
| 2020 June | 4 | 7 | 11 |
| 2020 May | 27 | 14 | 41 |
| 2020 April | 33 | 12 | 45 |
| 2020 March | 36 | 13 | 49 |
| 2020 February | 35 | 19 | 54 |
| 2020 January | 56 | 14 | 70 |
| 2019 December | 41 | 12 | 53 |
| 2019 November | 9 | 16 | 25 |
| 2019 October | 4 | 5 | 9 |
| 2019 September | 5 | 14 | 19 |
| 2019 August | 12 | 10 | 22 |
| 2019 July | 7 | 15 | 22 |
| 2019 June | 10 | 8 | 18 |
| 2019 May | 12 | 16 | 28 |
| 2019 April | 12 | 28 | 40 |
| 2019 March | 10 | 13 | 23 |
| 2019 February | 8 | 15 | 23 |
| 2019 January | 7 | 5 | 12 |
| 2018 December | 9 | 14 | 23 |
| 2018 November | 17 | 8 | 25 |
| 2018 October | 13 | 8 | 21 |
| 2018 September | 9 | 12 | 21 |
| 2018 May | 2 | 1 | 3 |
| 2018 April | 7 | 9 | 16 |
| 2018 March | 5 | 4 | 9 |
| 2018 February | 4 | 6 | 10 |
| 2018 January | 6 | 10 | 16 |
| 2017 December | 2 | 5 | 7 |
| 2017 November | 5 | 7 | 12 |
| 2017 October | 6 | 10 | 16 |
| 2017 September | 4 | 8 | 12 |
| 2017 August | 9 | 12 | 21 |
| 2017 July | 3 | 5 | 8 |
| 2017 June | 8 | 14 | 22 |
| 2017 May | 8 | 9 | 17 |
| 2017 April | 3 | 6 | 9 |
| 2017 March | 9 | 4 | 13 |
| 2017 February | 0 | 1 | 1 |
| 2017 January | 4 | 2 | 6 |
| 2016 December | 12 | 9 | 21 |
| 2016 November | 5 | 3 | 8 |
| 2016 October | 12 | 13 | 25 |
| 2016 September | 9 | 9 | 18 |
| 2016 August | 6 | 4 | 10 |
| 2016 July | 0 | 4 | 4 |
| 2016 March | 7 | 0 | 7 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 26 | 1 | 27 |
| 2015 September | 37 | 12 | 49 |
| 2015 August | 21 | 6 | 27 |
| 2015 July | 31 | 7 | 38 |
| 2015 June | 25 | 6 | 31 |
| 2015 May | 39 | 11 | 50 |
| 2015 April | 20 | 7 | 27 |
| 2015 March | 29 | 7 | 36 |
| 2015 February | 15 | 1 | 16 |
| 2015 January | 30 | 3 | 33 |
| 2014 December | 16 | 5 | 21 |
| 2014 November | 25 | 5 | 30 |
| 2014 October | 50 | 9 | 59 |
| 2014 September | 22 | 5 | 27 |
| 2014 August | 42 | 5 | 47 |
| 2014 July | 30 | 6 | 36 |
| 2014 June | 29 | 4 | 33 |
| 2014 May | 36 | 10 | 46 |
| 2014 April | 38 | 8 | 46 |
| 2014 March | 35 | 9 | 44 |
| 2014 February | 38 | 7 | 45 |
| 2014 January | 37 | 8 | 45 |
| 2013 December | 34 | 9 | 43 |
| 2013 November | 21 | 4 | 25 |
| 2013 October | 19 | 5 | 24 |
| 2013 September | 33 | 9 | 42 |
| 2013 August | 25 | 13 | 38 |
| 2013 July | 37 | 21 | 58 |
| 2013 June | 31 | 7 | 38 |
| 2013 May | 21 | 3 | 24 |
| 2013 April | 11 | 4 | 15 |
| 2013 March | 6 | 1 | 7 |
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