[Lung transplantation for emphysema: retrospective study of 65 patients].
OBJECTIVE
Our goal was to analyze the incidence of perioperative complications in patients with pulmonary emphysema who underwent lung transplantation and to identify variables associated with the incidence of morbidity and mortality during the immediate postoperative period.


METHODS
We undertook a retrospective study of 65 pulmonary emphysema patients who received lung transplants from 1994 through 2002 with the aim of determining the most common intra- and early postoperative complications in the ICU. An univariate analysis was carried out in order to identify variables associated with the incidence of mortality and postoperative complications. Those variables showing statistical significance underwent a multivariate analysis, by means of a pattern of logistic regression, in order to calculate the odds ratio and confidence interval.


RESULTS
Seventeen patients received single-lung transplants (SLT) and 48 patients received sequential double-lung transplants (DLT). Intraoperative complications appeared more frequently in the DLT group. Most frequent complications during surgery were reperfusion syndrome (44.6%) and pulmonary hypertension (16.9%). The intraoperative survival was 100%. Fifty-five patients had some type of postoperative complication. Commonest postoperative complications were infection (56.9%) and primary graft failure (36.6%). In the early postoperative period the mortality rate was 16.9%. Main cause of death in the ICU was sepsis (54.5%). A time of mechanical ventilation > 48 hours and postoperative hemorrhage were the variables with a higher predictive value for mortality in the early postoperative period.


CONCLUSIONS
Patients with SLT had a lower rate of perioperative complications and a higher survival during their stay in the ICU. Time of mechanical ventilation > 48 hours and postoperative hemorrhage were the variables that best predicted death in the early postoperative period following lung transplantation. Despite our experience, however, perioperative mortality in lung transplantation remains high up to this day.
Mayo-Moldes
Mónica
M
Servicio de Reanimación, Hospital Universitario La Fe, Valencia, Spain. mayomonica@wanadoo.es
Villalaín-Pérez
Cristina
C
Vicente-Guillén
Rosario
R
Ramos-Briones
Fernando
F
Calvo-Medina
Víctor
V
Morales-Marín
Pilar
P
Solé-Jover
Amparo
A
D005260:Female; D006801:Humans; D015994:Incidence; D016040:Lung Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011656:Pulmonary Emphysema / Q000601:surgery*; D012189:Retrospective Studies