Effect of cardiopulmonary bypass on early graft dysfunction in clinical lung transplantation

Ryo Aeba, Bartley P. Griffith, Robert L. Kormos, John M. Armitage, Thomas A. Gasior, Carl R. Fuhrman, Samuel A. Yousem, Robert L. Hardesty

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

The records of 100 lung transplant recipients (13 heart-lungs, 45 double-lungs, and 42 single-lungs) from September 1990 through April 1992 were reviewed to determine the role of cardiopulmonary bypass (CPB) in early graft dysfunction. Fifty-five patients requiring CPB (CPB group) for 186 ± 54 minutes were compared with the 45 patients without CPB (no-CPB group). All of the heartlung and en-bloc double-lung transplantations were petformed under CPB, with pulmonary vascular lung disease the principal diagnosis, resulting in a significantly younger age population in the CPB group. All other donor- and recipient-related factors matched well in both groups. Of 38 bilateral single-lung transplantations, CPB was used in 18. In double-lung and heart-lung recipients gas exchange of the allografts was evaluated by the arterial/alveolar oxygen tension ratios at nine intervals during the first 72 hours. The mean arterial/alveolar oxygen tension ratio in the CPB group was 0.48 ± 0.19, significantly lower than in the no-CPB group with 0.60 ± 0.22 (p = 0.025). All patients had radiographic interpretation and scoring of pulmonary infiltrates from chest roentgenograms taken within 12 hours after reperfusion. The CPB group had more severe pulmonary infiltrates than the no-CPB group (p = 0.034). Prolonged intubation defined as 7 days or longer occurred significantly more often ( 29 55) in the CPB group than in the no-CPB group ( 8 45) (p = 0.003). Actuarial graft and patient survival at 1 month was better in the no-CPB group than in the CPB group ( 42 45 versus 44 55 [p = 0.05] and 43 45 versus 45 55 [p = 0.033], respectively). These results suggest that the interaction between CPB and preservation injury exaggerates pulmonary dysfunction in clinical lung transplantation.

Original languageEnglish
Pages (from-to)715-722
Number of pages8
JournalThe Annals of thoracic surgery
Volume57
Issue number3
DOIs
Publication statusPublished - 1994
Externally publishedYes

Fingerprint

Lung Transplantation
Cardiopulmonary Bypass
Transplants
Lung
Oxygen
Lung Injury
Graft Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Aeba, R., Griffith, B. P., Kormos, R. L., Armitage, J. M., Gasior, T. A., Fuhrman, C. R., ... Hardesty, R. L. (1994). Effect of cardiopulmonary bypass on early graft dysfunction in clinical lung transplantation. The Annals of thoracic surgery, 57(3), 715-722. https://doi.org/10.1016/0003-4975(94)90573-8

Effect of cardiopulmonary bypass on early graft dysfunction in clinical lung transplantation. / Aeba, Ryo; Griffith, Bartley P.; Kormos, Robert L.; Armitage, John M.; Gasior, Thomas A.; Fuhrman, Carl R.; Yousem, Samuel A.; Hardesty, Robert L.

In: The Annals of thoracic surgery, Vol. 57, No. 3, 1994, p. 715-722.

Research output: Contribution to journalArticle

Aeba, R, Griffith, BP, Kormos, RL, Armitage, JM, Gasior, TA, Fuhrman, CR, Yousem, SA & Hardesty, RL 1994, 'Effect of cardiopulmonary bypass on early graft dysfunction in clinical lung transplantation', The Annals of thoracic surgery, vol. 57, no. 3, pp. 715-722. https://doi.org/10.1016/0003-4975(94)90573-8
Aeba, Ryo ; Griffith, Bartley P. ; Kormos, Robert L. ; Armitage, John M. ; Gasior, Thomas A. ; Fuhrman, Carl R. ; Yousem, Samuel A. ; Hardesty, Robert L. / Effect of cardiopulmonary bypass on early graft dysfunction in clinical lung transplantation. In: The Annals of thoracic surgery. 1994 ; Vol. 57, No. 3. pp. 715-722.
@article{97305ba50b54467fbd6a270d4929ad6b,
title = "Effect of cardiopulmonary bypass on early graft dysfunction in clinical lung transplantation",
abstract = "The records of 100 lung transplant recipients (13 heart-lungs, 45 double-lungs, and 42 single-lungs) from September 1990 through April 1992 were reviewed to determine the role of cardiopulmonary bypass (CPB) in early graft dysfunction. Fifty-five patients requiring CPB (CPB group) for 186 ± 54 minutes were compared with the 45 patients without CPB (no-CPB group). All of the heartlung and en-bloc double-lung transplantations were petformed under CPB, with pulmonary vascular lung disease the principal diagnosis, resulting in a significantly younger age population in the CPB group. All other donor- and recipient-related factors matched well in both groups. Of 38 bilateral single-lung transplantations, CPB was used in 18. In double-lung and heart-lung recipients gas exchange of the allografts was evaluated by the arterial/alveolar oxygen tension ratios at nine intervals during the first 72 hours. The mean arterial/alveolar oxygen tension ratio in the CPB group was 0.48 ± 0.19, significantly lower than in the no-CPB group with 0.60 ± 0.22 (p = 0.025). All patients had radiographic interpretation and scoring of pulmonary infiltrates from chest roentgenograms taken within 12 hours after reperfusion. The CPB group had more severe pulmonary infiltrates than the no-CPB group (p = 0.034). Prolonged intubation defined as 7 days or longer occurred significantly more often ( 29 55) in the CPB group than in the no-CPB group ( 8 45) (p = 0.003). Actuarial graft and patient survival at 1 month was better in the no-CPB group than in the CPB group ( 42 45 versus 44 55 [p = 0.05] and 43 45 versus 45 55 [p = 0.033], respectively). These results suggest that the interaction between CPB and preservation injury exaggerates pulmonary dysfunction in clinical lung transplantation.",
author = "Ryo Aeba and Griffith, {Bartley P.} and Kormos, {Robert L.} and Armitage, {John M.} and Gasior, {Thomas A.} and Fuhrman, {Carl R.} and Yousem, {Samuel A.} and Hardesty, {Robert L.}",
year = "1994",
doi = "10.1016/0003-4975(94)90573-8",
language = "English",
volume = "57",
pages = "715--722",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "3",

}

TY - JOUR

T1 - Effect of cardiopulmonary bypass on early graft dysfunction in clinical lung transplantation

AU - Aeba, Ryo

AU - Griffith, Bartley P.

AU - Kormos, Robert L.

AU - Armitage, John M.

AU - Gasior, Thomas A.

AU - Fuhrman, Carl R.

AU - Yousem, Samuel A.

AU - Hardesty, Robert L.

PY - 1994

Y1 - 1994

N2 - The records of 100 lung transplant recipients (13 heart-lungs, 45 double-lungs, and 42 single-lungs) from September 1990 through April 1992 were reviewed to determine the role of cardiopulmonary bypass (CPB) in early graft dysfunction. Fifty-five patients requiring CPB (CPB group) for 186 ± 54 minutes were compared with the 45 patients without CPB (no-CPB group). All of the heartlung and en-bloc double-lung transplantations were petformed under CPB, with pulmonary vascular lung disease the principal diagnosis, resulting in a significantly younger age population in the CPB group. All other donor- and recipient-related factors matched well in both groups. Of 38 bilateral single-lung transplantations, CPB was used in 18. In double-lung and heart-lung recipients gas exchange of the allografts was evaluated by the arterial/alveolar oxygen tension ratios at nine intervals during the first 72 hours. The mean arterial/alveolar oxygen tension ratio in the CPB group was 0.48 ± 0.19, significantly lower than in the no-CPB group with 0.60 ± 0.22 (p = 0.025). All patients had radiographic interpretation and scoring of pulmonary infiltrates from chest roentgenograms taken within 12 hours after reperfusion. The CPB group had more severe pulmonary infiltrates than the no-CPB group (p = 0.034). Prolonged intubation defined as 7 days or longer occurred significantly more often ( 29 55) in the CPB group than in the no-CPB group ( 8 45) (p = 0.003). Actuarial graft and patient survival at 1 month was better in the no-CPB group than in the CPB group ( 42 45 versus 44 55 [p = 0.05] and 43 45 versus 45 55 [p = 0.033], respectively). These results suggest that the interaction between CPB and preservation injury exaggerates pulmonary dysfunction in clinical lung transplantation.

AB - The records of 100 lung transplant recipients (13 heart-lungs, 45 double-lungs, and 42 single-lungs) from September 1990 through April 1992 were reviewed to determine the role of cardiopulmonary bypass (CPB) in early graft dysfunction. Fifty-five patients requiring CPB (CPB group) for 186 ± 54 minutes were compared with the 45 patients without CPB (no-CPB group). All of the heartlung and en-bloc double-lung transplantations were petformed under CPB, with pulmonary vascular lung disease the principal diagnosis, resulting in a significantly younger age population in the CPB group. All other donor- and recipient-related factors matched well in both groups. Of 38 bilateral single-lung transplantations, CPB was used in 18. In double-lung and heart-lung recipients gas exchange of the allografts was evaluated by the arterial/alveolar oxygen tension ratios at nine intervals during the first 72 hours. The mean arterial/alveolar oxygen tension ratio in the CPB group was 0.48 ± 0.19, significantly lower than in the no-CPB group with 0.60 ± 0.22 (p = 0.025). All patients had radiographic interpretation and scoring of pulmonary infiltrates from chest roentgenograms taken within 12 hours after reperfusion. The CPB group had more severe pulmonary infiltrates than the no-CPB group (p = 0.034). Prolonged intubation defined as 7 days or longer occurred significantly more often ( 29 55) in the CPB group than in the no-CPB group ( 8 45) (p = 0.003). Actuarial graft and patient survival at 1 month was better in the no-CPB group than in the CPB group ( 42 45 versus 44 55 [p = 0.05] and 43 45 versus 45 55 [p = 0.033], respectively). These results suggest that the interaction between CPB and preservation injury exaggerates pulmonary dysfunction in clinical lung transplantation.

UR - http://www.scopus.com/inward/record.url?scp=0028209381&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028209381&partnerID=8YFLogxK

U2 - 10.1016/0003-4975(94)90573-8

DO - 10.1016/0003-4975(94)90573-8

M3 - Article

C2 - 8147645

AN - SCOPUS:0028209381

VL - 57

SP - 715

EP - 722

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 3

ER -