Does the Pretransplant Use of Statins in Recipients Have a Role in the Incidence of Primary Graft Dysfunction after Lung Transplantation? R-ESTAcitos: Multicenter Clinical Study

• Published in: The Journal of heart and lung transplantation Vol. 39; no. 4; p. S162
• Main Authors: Bello, I., Sandiumenge, A., Coll, E., de la Torre, M., Mora, V., Crowley, S., Pérez, J., Mosteiro, F., Pérez, M., Ballesteros, Á., Álvarez, C., Escrivà, J., Galán, J., Gómez, A., Sacanell, J., Sánchez, L., Berastegui, C., Mazo, C., Deu, M., Jauregui, A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2020
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2020.01.1113

Primary graft dysfunction (PGD) is the main cause of mortality during the first month and the second one within the first year after lung transplant (LT) Statins, 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitors, have shown to have immunomodulatory and antiinflamatory effects unrelated to their cholesterol-lowering function. We hypothesized that recipient's preoperative statin therapy is associated with decreased incidence of PGD after LT. Multicenter retrospective analysis of all consecutive adult LTs performed in 5 university transplant centers between 2015 and 2017. Combined multiple organ transplantation and lung retransplant recipients were excluded from the analysis. Comparison between groups according to recipient previous use of statins(E+/E-)) was performed. Factors associated with the development of PGD and its severity were analyzed using Chisquare and U-Mann Whitney Test. Logistic regression model was built including those variables with p≤0.1 in the univariate analysis. Significance level p<0.05. A total of 474 adult LT recipients were reviewed, 110 of them (E+=23%) were on statins treatment (SG). LT recipients in the statin group were older (60±7 vs 53±12; p<0.05) and had higher Body Mass Index (BMI) (26.3±3.8 vs 24.8±4.2;p<0.05) than those in not taking statins. The rest of recipient and donor characteristics were similar between groups. A total of 161 patients developed PGD (34%), without significative differences between groups (32.2% vs 39%). However PGD in E+ group was significantly less severe as stated by the percentage of patients with grade 3 PGD at 72h (55.9% vs 37.2%,p<0.036). After propensity score adjustments, only the need for hemoderivates transfusion during the implant (OR 4.50 IC 1.51 - 13.38 p<0.007) remained significant. Recipient statin use was not identified as a protective factor (OR 0.38 CI 0.12 - 1.206, p=0.10). Statin use may contribute to lessen the severity of PGD. Prospective and multicentric studies with larger samples are needed to confirm such results.