Impact of graft ischemic time on outcomes after bilateral sequential single-lung transplantation.
BACKGROUND
Graft ischemic time (GIT) is a potential limiting factor in lung transplantation.


METHODS
Seventy-four patients who underwent bilateral sequential single-lung transplantation were divided into three groups: group I, GIT less than 5 hours (n = 20); group II, GIT between 5 and 8 hours (n = 39); and group III, GIT more than 8 hours (n = 15). We compared early allograft function (ratio of arterial oxygen tension to inspired oxygen fraction and alveolar-arterial oxygen gradient), blood loss, the need for tracheostomy, the duration of ventilation, intensive care unit stay, and hospital stay. We also compared prevalences of acute and chronic rejection, airway complications, lung function test, and 2-year survival.


RESULTS
Early allograft function in group III was significantly worse than those in groups I and II. However, there was no significant difference in any other variables of early and medium-term outcomes among the three groups. No significant correlation was detected between GIT and duration of intensive care unit stay or hospital stay.


CONCLUSIONS
The limitation of acceptable GIT could be extended from the traditionally approved 4 to 5 hours, to 5 to 8 hours or even longer.
Ueno
T
T
Heart and Lung Transplant Service, Alfred Hospital, Victoria, Australia.
Snell
G I
GI
Williams
T J
TJ
Kotsimbos
T C
TC
Smith
J A
JA
Rabinov
M
M
Esmore
D S
DS
D000328:Adult; D002315:Cardiopulmonary Bypass; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D006982:Hypertonic Solutions; D007902:Length of Stay; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019188:Organ Preservation Solutions; D010100:Oxygen / Q000378:metabolism; D013997:Time Factors; D014021:Tissue Preservation; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014797:Vital Capacity
C037096:Euro-Collins' solution; D006982:Hypertonic Solutions; D019188:Organ Preservation Solutions; D010100:Oxygen