Complications after lung transplantation in chronic obstructive pulmonary disease

• Published in: Medicina clinica Vol. 140; no. 9; p. 385
• Main Authors: Cerón Navarro, José, de Aguiar Quevedo, Karol, Mancheño Franch, Nuria, Peñalver Cuesta, Juan Carlos, Vera Sempere, Francisco José, Padilla Alarcón, José
• Format: Journal Article
• Language: Spanish
• Published: Spain 04.05.2013
• Subjects: Comorbidity; Female; Graft Rejection - epidemiology; Hemothorax - epidemiology; Hemothorax - etiology; Humans; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Kaplan-Meier Estimate; Lung Transplantation - adverse effects; Lung Transplantation - mortality; Male; Middle Aged; Phrenic Nerve - injuries; Pleural Effusion - epidemiology; Pleural Effusion - etiology; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative Hemorrhage - epidemiology; Postoperative Hemorrhage - etiology; Primary Graft Dysfunction - epidemiology; Proportional Hazards Models; Pulmonary Disease, Chronic Obstructive - surgery; Respiratory Function Tests; Respiratory Paralysis - epidemiology; Respiratory Paralysis - etiology; Retrospective Studies; Smoking - adverse effects; Spain - epidemiology; Survival Rate; Spain
• ISSN: 1578-8989
• DOI: 10.1016/j.medcli.2012.07.028

Lung transplantation (LT) in chronic obstructive pulmonary disease (COPD) is a procedure with a high rate of morbimortality. The aim of this paper is to analyze the early and late rates of complications and mortality in COPD patients undergoing LT. Retrospective study of 107 COPD patients transplanted in the Hospital Universitario La Fe, between 1991 and 2008. Preoperative variables were collected as well as all the complications, medical and surgical, occurred in the follow-up, which are expressed as mean or percentage as appropriate. The 30-day mortality and long term survival were established. A total of 94 men (87.9%) and 13 women (12.1%) were transplanted with a mean age (SD) of 52.58 (8.05) years with 71% of double-lung LT. BODE score was 7.24 (1.28). The rate of primary graft dysfunction was 39.3%. The most common surgical complications were phrenic paralysis (16.8%), hemothorax (17.8%) and pleural effusion (30.8%). There was a high number of postoperative hospitalization (30%) and medical complications such as hypertension (36%), diabetes mellitus (16.7%) and renal failure (40%), secondary to treatment. Perioperative mortality was 14% and 34.5% after a year, being the most frequent causes infections (34.6%) and chronic rejection (BOS) (17.8%). Five-year survival was 40.9% with bronchiectasis and smoking history being the risk factors. LT is a procedure with a high early mortality rate associated with high medical and surgical complications that affect the outcome.