Charles F Evans1, Aldo T Iacono2, Pablo G Sanchez1, Olga Goloubeva3, June Kim4, Irina Timofte4, Faisal H Cheema1, Si M Pham1, Bartley P Griffith1, Keshava Rajagopal5. 1. Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland. 2. Pulmonary and Critical Care Medicine, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland. 3. Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland. 4. Division of Pulmonary and Critical Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland. 5. Department of Cardiothoracic and Vascular Surgery, The University of Texas Medical School at Houston, Houston, Texas. Electronic address: keshava.rajagopal@uth.tmc.edu.
Abstract
BACKGROUND: The incidence and consequences of deep venous thrombosis (DVT) and pulmonary embolism (PE) have not been described recently in lung transplant recipients. We sought to characterize DVT and PE in a contemporary series of lung transplant recipients and describe their association with clinical outcomes. METHODS: The records of all lung transplant recipients from July 1, 2008, to June 30, 2013, were reviewed and analyzed. DVT was diagnosed by venous duplex ultrasonography. PE was diagnosed by computed tomography angiography, nuclear ventilation/perfusion scanning, or pulmonary angiography. RESULTS: The study comprised 117 patients who underwent 123 transplants. The median age was 63 years (range, 17 to 77 years). Forty-five patients (39%) had evidence of lower extremity DVT, 53 (45%) had no evidence of lower extremity DVT, and 19 (16%) were not tested. Fifty-three (45%) had evidence of upper extremity DVT, 30 (26%) had no evidence of upper extremity DVT, and 34 (29%) were not tested. Eighteen (15%) had evidence of PE, 82 (70%) had no evidence of PE, and 17 (15%) were not tested. A multivariable, stepwise Cox proportional hazards model revealed that the presence of lower extremity DVT (hazard ratio, 2.43; 95% confidence interval, 1.29 to 4.64), use of cardiopulmonary bypass (hazard ratio, 2.21; 95% confidence interval, 1.04 to 4.68), and unilateral lung transplantation (hazard ratio, 2.13; 95% confidence interval, 1.07 to 4.25) were associated with diminished survival. CONCLUSIONS: The incidence of DVT and PE in lung transplant recipients is high. Posttransplant surveillance and treatment based on findings are warranted.
BACKGROUND: The incidence and consequences of deep venous thrombosis (DVT) and pulmonary embolism (PE) have not been described recently in lung transplant recipients. We sought to characterize DVT and PE in a contemporary series of lung transplant recipients and describe their association with clinical outcomes. METHODS: The records of all lung transplant recipients from July 1, 2008, to June 30, 2013, were reviewed and analyzed. DVT was diagnosed by venous duplex ultrasonography. PE was diagnosed by computed tomography angiography, nuclear ventilation/perfusion scanning, or pulmonary angiography. RESULTS: The study comprised 117 patients who underwent 123 transplants. The median age was 63 years (range, 17 to 77 years). Forty-five patients (39%) had evidence of lower extremity DVT, 53 (45%) had no evidence of lower extremity DVT, and 19 (16%) were not tested. Fifty-three (45%) had evidence of upper extremity DVT, 30 (26%) had no evidence of upper extremity DVT, and 34 (29%) were not tested. Eighteen (15%) had evidence of PE, 82 (70%) had no evidence of PE, and 17 (15%) were not tested. A multivariable, stepwise Cox proportional hazards model revealed that the presence of lower extremity DVT (hazard ratio, 2.43; 95% confidence interval, 1.29 to 4.64), use of cardiopulmonary bypass (hazard ratio, 2.21; 95% confidence interval, 1.04 to 4.68), and unilateral lung transplantation (hazard ratio, 2.13; 95% confidence interval, 1.07 to 4.25) were associated with diminished survival. CONCLUSIONS: The incidence of DVT and PE in lung transplant recipients is high. Posttransplant surveillance and treatment based on findings are warranted.
Authors: Manuel L Ribeiro Neto; Marie Budev; Daniel A Culver; C Randall Lane; Marcelo Gomes; Xiao-Feng Wang; Paulo Novis Rocha; Mitchell A Olman Journal: Transplantation Date: 2018-04 Impact factor: 4.939
Authors: Hailey M Shepherd; Ramsey R Hachem; Chad A Witt; Rodrigo V Guillamet; Derek E Byers; Benjamin D Kozower; Bryan F Meyers; Tsuyoshi Takahashi; G Alexander Patterson; Varun Puri; Daniel Kreisel; Ruben G Nava Journal: J Thorac Dis Date: 2022-08 Impact factor: 3.005