title: Prognostic factors in lung transplantation: the Santa Casa de Porto Alegre experience.
abstract: BACKGROUND
  Lung transplantation (LT) has been established as a current therapy for selected patients with end-stage lung disease. Different prognostic factors have been reported by transplant centers. The objective of this study is to report our recent results with LT and to search for prognostic factors.
  
  
  METHODS
  We performed a retrospective analysis of 130 patients who underwent LT at our institution from January 2004 to July 2009. Donor, recipient, intraoperative, and postoperative variables were collected.
  
  
  RESULTS
  The mean age was 53.14 years (ranging from 8 to 72 years) and 80 (61.5%) were male. The main causes of end-stage respiratory disease were pulmonary fibrosis 53 (40.7%) and chronic obstructive pulmonary disease 52 (40%). The actuarial 1-year survival was 67.7%. Variables correlated with survival were age (P=0.004), distance in the 6-min walk test (P=0.007), coronary heart disease (P=0.001), cardiopulmonary bypass (P=0.02), intraoperative transfusion of red blood cells (P=0.016), increasing central venous pressure at 24th postoperative hour (P=0.001), increasing pulmonary capillary wedge pressure at 24th postoperative hour (P=0.01); length of intubation (P<0.01), reintubation (P=0.001), length of intensive care unit stay (P<0.001), abdominal complication (P=0.003), acute renal failure requiring dialysis (P<0.001), native lung hyperinflation (P=0.02), and acute rejection in the first month (P=0.03). In multivariate analysis, only dialysis (P=0.004, hazards ratio [HR] 2.68), length of intubation (P=0.004, HR 1.002 for each hour), and reintubation (P=0.003, HR 2.88) proved to be independent predictors.
  
  
  CONCLUSIONS
  Analysis of variables in our cohort highlighted dialysis, longer mechanical ventilation requirement, and reintubation as independent prognostic factors in LT.
authors.affiliation: Thoracic Surgery Division, Pavilhão Pereira Filho, Santa Casa de Porto Alegre, Porto Alegre, Brazil. machuca36@hotmail.com
authors.forename: Tiago Noguchi
authors.initials: TN
authors.lastname: Machuca
authors.forename: Sadi Marcelo
authors.initials: SM
authors.lastname: Schio
authors.forename: Spencer Marcantônio
authors.initials: SM
authors.lastname: Camargo
authors.forename: Vivalde
authors.initials: V
authors.lastname: Lobato
authors.forename: Clarice Daniele Oliveira
authors.initials: CD
authors.lastname: Costa
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Felicetti
authors.forename: José Silva
authors.initials: JS
authors.lastname: Moreira
authors.forename: José Jesus
authors.initials: JJ
authors.lastname: Camargo
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil; D002315:Cardiopulmonary Bypass; D002496:Central Venous Pressure; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000209:etiology; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D014019:Tissue Donors