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The Impact of New Treatments on Short- and MID-Term Outcomes in Bilateral Lung Transplant: A Propensity Score Study
Background: Despite many efforts to improve organ preservation and recipient survival, overall lung transplant (LT) mortality is still high. We aimed to investigate the impact of ‘prophylactic’ veno-arterial extracorporeal membrane oxygenation (VA ECMO) and tacrolimus on 72-h primary graft dysfuncti...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9571142/ https://www.ncbi.nlm.nih.gov/pubmed/36233726 http://dx.doi.org/10.3390/jcm11195859 |
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author | Boscolo, Annalisa Dell’Amore, Andrea Pettenuzzo, Tommaso Sella, Nicolò De Cassai, Alessandro Pistollato, Elisa Cacco, Nicola Manzan, Andrea De Carolis, Agnese Geraldini, Federico Lorenzoni, Giulia Pezzuto, Federica Zambello, Giovanni Schiavon, Marco Calabrese, Fiorella Gregori, Dario Cozzi, Emanuele Rea, Federico Navalesi, Paolo |
author_facet | Boscolo, Annalisa Dell’Amore, Andrea Pettenuzzo, Tommaso Sella, Nicolò De Cassai, Alessandro Pistollato, Elisa Cacco, Nicola Manzan, Andrea De Carolis, Agnese Geraldini, Federico Lorenzoni, Giulia Pezzuto, Federica Zambello, Giovanni Schiavon, Marco Calabrese, Fiorella Gregori, Dario Cozzi, Emanuele Rea, Federico Navalesi, Paolo |
author_sort | Boscolo, Annalisa |
collection | PubMed |
description | Background: Despite many efforts to improve organ preservation and recipient survival, overall lung transplant (LT) mortality is still high. We aimed to investigate the impact of ‘prophylactic’ veno-arterial extracorporeal membrane oxygenation (VA ECMO) and tacrolimus on 72-h primary graft dysfunction (PGD) and 30-day acute cellular rejection, respectively. Methods: All consecutive LT patients admitted to the Intensive Care Unit of the Padua University Hospital (February, 2016–2022) were screened. Only adult patients undergoing first bilateral LT and not requiring cardio-pulmonary bypass, invasive mechanical ventilation, and/or ECMO before LT, were included. A propensity score weighting analysis was employed to account for the non-random allocation of the subjects to different treatments. Results: A total of 128 LT recipients were enrolled. Compared to the ‘off-pump’-group (n.47, 37%), ‘prophylactic’ VA ECMO (n.51,40%) recorded similar 72-h PGD values, perioperative blood products and lower acute kidney dysfunction. Compared with cyclosporine (n.86, 67%), tacrolimus (n.42, 33%) recorded a lower risk of 30-day cellular rejection, kidney dysfunction, and bacteria isolation. Conclusions: ‘Prophylactic’ VA ECMO recorded 72-h PGD values comparable to the ‘off-pump’-group; while tacrolimus showed a lower incidence of 30-day acute cellular rejection. |
format | Online Article Text |
id | pubmed-9571142 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-95711422022-10-17 The Impact of New Treatments on Short- and MID-Term Outcomes in Bilateral Lung Transplant: A Propensity Score Study Boscolo, Annalisa Dell’Amore, Andrea Pettenuzzo, Tommaso Sella, Nicolò De Cassai, Alessandro Pistollato, Elisa Cacco, Nicola Manzan, Andrea De Carolis, Agnese Geraldini, Federico Lorenzoni, Giulia Pezzuto, Federica Zambello, Giovanni Schiavon, Marco Calabrese, Fiorella Gregori, Dario Cozzi, Emanuele Rea, Federico Navalesi, Paolo J Clin Med Article Background: Despite many efforts to improve organ preservation and recipient survival, overall lung transplant (LT) mortality is still high. We aimed to investigate the impact of ‘prophylactic’ veno-arterial extracorporeal membrane oxygenation (VA ECMO) and tacrolimus on 72-h primary graft dysfunction (PGD) and 30-day acute cellular rejection, respectively. Methods: All consecutive LT patients admitted to the Intensive Care Unit of the Padua University Hospital (February, 2016–2022) were screened. Only adult patients undergoing first bilateral LT and not requiring cardio-pulmonary bypass, invasive mechanical ventilation, and/or ECMO before LT, were included. A propensity score weighting analysis was employed to account for the non-random allocation of the subjects to different treatments. Results: A total of 128 LT recipients were enrolled. Compared to the ‘off-pump’-group (n.47, 37%), ‘prophylactic’ VA ECMO (n.51,40%) recorded similar 72-h PGD values, perioperative blood products and lower acute kidney dysfunction. Compared with cyclosporine (n.86, 67%), tacrolimus (n.42, 33%) recorded a lower risk of 30-day cellular rejection, kidney dysfunction, and bacteria isolation. Conclusions: ‘Prophylactic’ VA ECMO recorded 72-h PGD values comparable to the ‘off-pump’-group; while tacrolimus showed a lower incidence of 30-day acute cellular rejection. MDPI 2022-10-03 /pmc/articles/PMC9571142/ /pubmed/36233726 http://dx.doi.org/10.3390/jcm11195859 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Boscolo, Annalisa Dell’Amore, Andrea Pettenuzzo, Tommaso Sella, Nicolò De Cassai, Alessandro Pistollato, Elisa Cacco, Nicola Manzan, Andrea De Carolis, Agnese Geraldini, Federico Lorenzoni, Giulia Pezzuto, Federica Zambello, Giovanni Schiavon, Marco Calabrese, Fiorella Gregori, Dario Cozzi, Emanuele Rea, Federico Navalesi, Paolo The Impact of New Treatments on Short- and MID-Term Outcomes in Bilateral Lung Transplant: A Propensity Score Study |
title | The Impact of New Treatments on Short- and MID-Term Outcomes in Bilateral Lung Transplant: A Propensity Score Study |
title_full | The Impact of New Treatments on Short- and MID-Term Outcomes in Bilateral Lung Transplant: A Propensity Score Study |
title_fullStr | The Impact of New Treatments on Short- and MID-Term Outcomes in Bilateral Lung Transplant: A Propensity Score Study |
title_full_unstemmed | The Impact of New Treatments on Short- and MID-Term Outcomes in Bilateral Lung Transplant: A Propensity Score Study |
title_short | The Impact of New Treatments on Short- and MID-Term Outcomes in Bilateral Lung Transplant: A Propensity Score Study |
title_sort | impact of new treatments on short- and mid-term outcomes in bilateral lung transplant: a propensity score study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9571142/ https://www.ncbi.nlm.nih.gov/pubmed/36233726 http://dx.doi.org/10.3390/jcm11195859 |
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