Ischemia-reperfusion injury after lung transplantation increases risk of late bronchiolitis obliterans syndrome

Steven M. Fiser, Curtis G. Tribble, Stewart M. Long, Aditya K. Kaza, John A. Kern, David R. Jones, Mark K. Robbins, Irving L. Kron

Research output: Contribution to journalArticle

209 Citations (Scopus)

Abstract

Background. Bronchiolitis obliterans syndrome (BOS) is the most common cause of long-term morbidity and mortality after lung transplantation. Our hypothesis was that early ischemia-reperfusion injury after lung transplantation increases the risk of BOS. Methods. Data on 134 patients who had lung transplantation between January 1, 1990 and January 1, 2000, was used for univariate and multivariate logistic regression analysis. Results. After lung transplantation, 115 patients (115 of 134, 86%) survived more than 3 months. In that group, 41 patients developed BOS, of which 23 had progressive disease. Univariate analysis revealed that ischemia-reperfusion injury (p = 0.017) and two or more acute rejection episodes (p = 0.032) were predictors of BOS onset, whereas ischemia-reperfusion injury (p = 0.011) and cytomegalovirus infection (p = 0.009) predicted progressive BOS. Multivariate logistic regression analysis showed that ischemia-reperfusion injury was an independent predictor for both BOS development and BOS progression. Two or more acute rejection episodes were also an independent predictor of BOS development, whereas cytomegalovirus infection was an independent predictor of progressive BOS. Conclusions. Ischemia-reperfusion injury increases the risk of BOS after lung transplantation.

Original languageEnglish (US)
Pages (from-to)1041-1048
Number of pages8
JournalAnnals of Thoracic Surgery
Volume73
Issue number4
DOIs
StatePublished - Apr 15 2002
Externally publishedYes

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Bronchiolitis Obliterans
Bacterial Pneumonia
Lung Transplantation
Cytomegalovirus Infections
Graft Rejection
Reperfusion Injury
Disease Progression
Multivariate Analysis
Retrospective Studies
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Ischemia-reperfusion injury after lung transplantation increases risk of late bronchiolitis obliterans syndrome. / Fiser, Steven M.; Tribble, Curtis G.; Long, Stewart M.; Kaza, Aditya K.; Kern, John A.; Jones, David R.; Robbins, Mark K.; Kron, Irving L.

In: Annals of Thoracic Surgery, Vol. 73, No. 4, 15.04.2002, p. 1041-1048.

Research output: Contribution to journalArticle

Fiser, Steven M. ; Tribble, Curtis G. ; Long, Stewart M. ; Kaza, Aditya K. ; Kern, John A. ; Jones, David R. ; Robbins, Mark K. ; Kron, Irving L. / Ischemia-reperfusion injury after lung transplantation increases risk of late bronchiolitis obliterans syndrome. In: Annals of Thoracic Surgery. 2002 ; Vol. 73, No. 4. pp. 1041-1048.
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abstract = "Background. Bronchiolitis obliterans syndrome (BOS) is the most common cause of long-term morbidity and mortality after lung transplantation. Our hypothesis was that early ischemia-reperfusion injury after lung transplantation increases the risk of BOS. Methods. Data on 134 patients who had lung transplantation between January 1, 1990 and January 1, 2000, was used for univariate and multivariate logistic regression analysis. Results. After lung transplantation, 115 patients (115 of 134, 86{\%}) survived more than 3 months. In that group, 41 patients developed BOS, of which 23 had progressive disease. Univariate analysis revealed that ischemia-reperfusion injury (p = 0.017) and two or more acute rejection episodes (p = 0.032) were predictors of BOS onset, whereas ischemia-reperfusion injury (p = 0.011) and cytomegalovirus infection (p = 0.009) predicted progressive BOS. Multivariate logistic regression analysis showed that ischemia-reperfusion injury was an independent predictor for both BOS development and BOS progression. Two or more acute rejection episodes were also an independent predictor of BOS development, whereas cytomegalovirus infection was an independent predictor of progressive BOS. Conclusions. Ischemia-reperfusion injury increases the risk of BOS after lung transplantation.",
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AU - Kern, John A.

AU - Jones, David R.

AU - Robbins, Mark K.

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