HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): K. Eric Sommers Bartley P. Griffith Robert L. Hardesty Robert J. Keenan Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sommers, K. E. Articles by Keenan, R. J. Search for Related Content PubMed PubMed Citation Articles by Sommers, K. E. Articles by Keenan, R. J. Related Collections Related Article

Ann Thorac Surg 1996;62:784-790
© 1996 The Society of Thoracic Surgeons

---

Original Articles: General Thoracic

Early Lung Allograft Function in Twin Recipients From the Same Donor: Risk Factor Analysis

Division of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania

Background. Transplantation of lung allografts from the same donor into 2 recipients ("twinning") provides an opportunity to study recipient and donor factors that influence early allograft function.

Methods. Twenty-seven pairs of recipients were identified and evaluated using multivariate logistic regression analysis (p < 0.05). Four measures of early graft function were analyzed: alveolar-arterial gradient in the operating room, first alveolar-arterial gradient in the intensive care unit, alveolar-arterial gradient at 24 hours, and days of mechanical ventilation.

Results. Analysis of the pooled data without regard to pairing showed that alveolar-arterial gradient in the operating room was influenced by donor age, length of donor hospitalization, recipient mean pulmonary artery (PA) pressure at unclamping, and transplantation of a left lung. The alveolar-arterial gradient in the intensive care unit was correlated with donor age, donor cause of death, and mean PA pressure on arrival in that unit. Only mean PA pressure remained significant at 24 hours. Days of mechanical ventilation was determined by mean PA pressure on arrival in the intensive care unit, drop in mean PA pressure during operation, and diagnosis of the recipient. In the paired analysis, receiving a left lung, recipient diagnosis (pulmonary hypertension worse than others), and need of cardiopulmonary bypass were significantly associated with immediate graft dysfunction, although these influences did not persist beyond the immediate postoperative period. Donor arterial oxygen tension and time of ischemia were not significant predictors in any analysis.

Conclusions. Immediate allograft function was associated with donor-related characteristics initially, but these lost importance over the ensuing 24 hours. Recipient PA pressure was an immediate and persisting influence. In the analysis of differences in function between the members of each pair, transplantation of the left lung, recipient diagnosis, and cardiopulmonary bypass were identified, but their influence did not persist beyond the first 6 hours.

Related Article

Discussion
Ann. Thorac. Surg. 1996 62: 790. [Extract] [Full Text]

This article has been cited by other articles:

				D. Van Raemdonck, A. Neyrinck, G. M. Verleden, L. Dupont, W. Coosemans, H. Decaluwe, G. Decker, P. De Leyn, P. Nafteux, and T. Lerut Lung Donor Selection and Management Proceedings of the ATS, January 15, 2009; 6(1): 28 - 38. [Abstract] [Full Text] [PDF]

				J. C. Lee and J. D. Christie Primary Graft Dysfunction Proceedings of the ATS, January 15, 2009; 6(1): 39 - 46. [Abstract] [Full Text] [PDF]

				T. Oto, B. J. Levvey, H. Whitford, A. P. Griffiths, T. Kotsimbos, T. J. Williams, and G. I. Snell Feasibility and Utility of a Lung Donor Score: Correlation With Early Post-Transplant Outcomes Ann. Thorac. Surg., January 1, 2007; 83(1): 257 - 263. [Abstract] [Full Text] [PDF]

				I. Al-Githmi, N. Batawil, N. Shigemura, M. Hsin, T. W. lee, G.-W. He, and A. Yim Bronchiolitis obliterans following lung transplantation Eur. J. Cardiothorac. Surg., December 1, 2006; 30(6): 846 - 851. [Abstract] [Full Text] [PDF]

				D.V. Pilcher, C.D. Scheinkestel, G.I. Snell, A. Davey-Quinn, M.J. Bailey, and T.J. Williams High central venous pressure is associated with prolonged mechanical ventilation and increased mortality after lung transplantation J. Thorac. Cardiovasc. Surg., April 1, 2005; 129(4): 912 - 918. [Abstract] [Full Text] [PDF]

				S. Keshavjee, R.D. Davis, M.R. Zamora, M. de Perrot, and G.A. Patterson A randomized, placebo-controlled trial of complement inhibition in ischemia-reperfusion injury after lung transplantation in human beings J. Thorac. Cardiovasc. Surg., February 1, 2005; 129(2): 423 - 428. [Abstract] [Full Text] [PDF]

				M. de Perrot, K. Young, Y. Imai, M. Liu, T. K. Waddell, S. Fischer, L. Zhang, and S. Keshavjee Recipient T Cells Mediate Reperfusion Injury after Lung Transplantation in the Rat J. Immunol., November 15, 2003; 171(10): 4995 - 5002. [Abstract] [Full Text] [PDF]

				M. de Perrot, M. Liu, T. K. Waddell, and S. Keshavjee Ischemia-Reperfusion-induced Lung Injury Am. J. Respir. Crit. Care Med., February 15, 2003; 167(4): 490 - 511. [Abstract] [Full Text] [PDF]

				D. Zaas and S. M. Palmer Respiratory Failure Early After Lung Transplantation: Now That We Know the Extent of the Problem, What Are the Solutions? Chest, January 1, 2003; 123(1): 14 - 16. [Full Text] [PDF]

				W. M. Chatila, S. Furukawa, J. P. Gaughan, and G. J. Criner Respiratory Failure After Lung Transplantation Chest, January 1, 2003; 123(1): 165 - 173. [Abstract] [Full Text] [PDF]

				G. THABUT, I. VINATIER, O. BRUGIERE, G. LESECHE, P. LOIRAT, A. BISSON, J. MARTY, M. FOURNIER, and H. MAL Influence of Preservation Solution on Early Graft Failure in Clinical Lung Transplantation Am. J. Respir. Crit. Care Med., October 1, 2001; 164(7): 1204 - 1208. [Abstract] [Full Text] [PDF]

				D. M. Meyer, L. E. Bennett, R. J. Novick, and J. D. Hosenpud Effect of Donor Age and Ischemic Time on Intermediate Survival and Morbidity After Lung Transplantation Chest, November 1, 2000; 118(5): 1255 - 1262. [Abstract] [Full Text] [PDF]

				J. S. Gammie, D. R. Stukus, S. M. Pham, B. G. Hattler, M. F. McGrath, K. R. McCurry, B. P. Griffith, and R. J. Keenan Effect of ischemic time on survival in clinical lung transplantation Ann. Thorac. Surg., December 1, 1999; 68(6): 2015 - 2019. [Abstract] [Full Text] [PDF]

				F. Venuta, A. Boehler, E. A. Rendina, T. De Giacomo, R. Speich, R. Schmid, G. Funo Coloni, and W. Weder Complications in the native lung after single lung transplantation Eur. J. Cardiothorac. Surg., July 1, 1999; 16(1): 54 - 58. [Abstract] [Full Text] [PDF]

				J. C. Wain, C. D. Wright, D. P. Ryan, S. L. Zorb, D. J. Mathisen, and L. C. Ginns Induction immunosuppression for lung transplantation with OKT3 Ann. Thorac. Surg., January 1, 1999; 67(1): 187 - 193. [Abstract] [Full Text] [PDF]