title: Pretransplant dyslipidaemia determines outcome in lung transplant recipients.
abstract: BACKGROUND
  There is little knowledge about the effect of dyslipidaemia on the outcome after lung transplantation. Thus, the aim of this retrospective single centre study was to analyse the impact of the plasma lipid profile on mortality in lung transplant recipients. From January 2000 to December 2008 the charts of 172 consecutive lung transplantation recipients were analysed. At baseline and after one year lipid profiles were routinely collected. During the follow-up major cardiovascular events (MCE; beginning of dialysis, cerebrovascular insult or myocardial infarction) were recorded. The follow-up period ended December 2010.
  
  
  RESULTS
  Over all total cholesterol (4.3 ± 1.6 vs. 5.4 ± 1.3 mmol/l, p < 0.0001), triglycerides (1.2 ± 0.7 vs. 2.4 ± 1.3 mmol/l, p < 0.0001), HDL (1.5 ± 0.6 vs. 1.7 ± 0.6 mmol/l, p = 0.003) and TC/HDL ratio (3.0 ± 1.0 vs. 3.6 ± 1.2, p = 0.002) increased significantly after 1 year.During the observational period 6.9% (10 patients) suffered a major cardiac event. In univariate analysis MCE was associated with baseline TC: on average the event-group had a 33% higher baseline TC (5.6 vs. 4.2 mmol/l, OR 1.6, CI 1.1 - 2.2, p = 0.02). The total mortality in the observational period was 25% (36 patients overall). In univariate analysis mortality was associated with increased TC/HDL ratio. The non-survivors had on average a 22% higher baseline TC/HDL ratio (3.6 vs. 2.8, HR 2.8, CI 1.2 - 3.5, p = 0.001). There was no association between mortality and TC (p = 0.33), triglycerides (p = 0.34), HDL (p = 0.78) and creatinine (p = 0.73). In a multivariate model the hazard ratio was 1.5 (1.2 - 1.9, p = 0.001) per increase of 0.4 TC/HDL ratio.
  
  
  CONCLUSIONS
  This study shows that the total cholesterol before transplantation is associated with the incidence of MCE and the cholesterol/HDL ratio with mortality in lung transplanted recipients.
authors.affiliation: Surgical Intensive Care Medicine, University Hospital of Zurich, Zurich, Switzerland.
authors.forename: Urs
authors.initials: U
authors.lastname: Wenger
authors.forename: Silvia R
authors.initials: SR
authors.lastname: Cottini
authors.forename: Georg
authors.initials: G
authors.lastname: Noll
authors.forename: Stefan
authors.initials: S
authors.lastname: Arndt
authors.forename: Paul A
authors.initials: PA
authors.lastname: Stehberger
authors.forename: Stefanie
authors.initials: S
authors.lastname: Klinzing
authors.forename: Reto A
authors.initials: RA
authors.lastname: Schuepbach
authors.forename: Markus
authors.initials: M
authors.lastname: Béchir
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood* / Q000209:etiology / Q000401:mortality*; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003404:Creatinine / Q000097:blood; D050171:Dyslipidemias / Q000097:blood* / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood; D016040:Lung Transplantation / Q000009:adverse effects / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008075:Lipoproteins, HDL; D014280:Triglycerides; C035392:high density lipoprotein-1; D002784:Cholesterol; D003404:Creatinine