Impact of ischemia-reperfusion injury on outcome following lung transplantation

Abstract

Objective Primary graft dysfunction (PGD) is a severe form of ischemia-reperfusion injury (IRI) developing in the early days of post-lung transplantation (LT).We aimed to investigate the incidence and severity grading of PGD,and analyze the impact of PGD on early morbidity and mortality after LT as well as on long-term function and survival.Method Twenty-eight consecutive recipients undergoing LT were collected at Beijing Chao-Yang Hospital between Aug.2005 and Dec.2010,and 24 LT recipients were enrolled in this study.The incidence of PGD was calculated and the recipients were classified by standardized consensus criteria reported by the International Society for Heart and Lung Transplantation (ISHLT) Working Group on PGD.The difference was compared among T0-24,T24-48 and T48-72.The incidence of PGD,PGD grading and impact of PGD on early morbidity and mortality after LT as well as on long-term function and survival were analyzed.Result The incidence of PGD after LT was 66.7％ (16/24).The incidence of severe PGD (grading 3) was 54.2％ (13/24).There was significant difference among T0-24,T24-48 and T48-72 in the severity grading of PGD (P＜0.01).At 30th day and 3rd month post-LT,one and 4 died,respectively,among LT recipients with PGD.There was no death in LT recipients without PGD.The all-cause mortality rate had no statistically significant difference between the two groups (P ＞ 0.05).The median duration of mechanical ventilation in LT recipients with or without PGD was 91.1 h and 19.2 h respectively (P＜0.05).The improvements of pulmonary function and 6 Minute Walk Test (6MWT) within one year after LT showed no statistically significant difference between LT recipients with PGD and those without PGD (P ＞ 0.05 ). Conclusion MBL gene single nucleotide polymorphisms may influence CMV infection after HSCT. Key words: Ischemia; Reperfution injure; Lung transplantation; Survival rate