THE EFFECT OF PRIMARY GRAFT DYSFUNCTION ON LUNG TRANSPLANT SURVIVAL
Using data collected on 5,262 patients from the United Network for Organ Sharing/International Society of Heart and Lung Transplant Registry who were operated on between 1994 and 2000, researchers found that over 43 percent of those who died within 30 days after transplantation had primary graft dysfunction.
The researchers were trying to test the association between primary graft dysfunction with individual short- and long-term mortality after lung transplantation. Outcomes studied included mortality at 30 days and 1 year after transplantation.
They said that primary graft dysfunction occurs in the first hours to days after transplantation and that the clinical course and pathophysiology of the most severe forms were similar to that of acute respiratory distress syndrome. With an incidence reported between 10 and 25 percent, primary graft dysfunction represents the leading cause of death after transplantation.
The overall incidence of primary graft dysfunction during the study period was 10.2 percent. The incidence did not vary by year over the period of the observation.
Dr. Christie said that a key finding of the study was that subjects who survive one year after primary graft dysfunction continue to have a higher risk of mortality over the next four years.
The authors pointed out that their data reinforce the importance of efforts aimed at further research into the prevention and early treatment of primary graft dysfunction.
The study appears in the first issue for June 2005 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine.