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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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.
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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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