title: Venous Thromboembolic Complications of Lung Transplantation: A Contemporary Single-Institution Review.
abstract: BACKGROUND
  The incidence and consequences of deep venous thrombosis (DVT) and pulmonary embolism (PE) have not been described recently in lung transplant recipients. We sought to characterize DVT and PE in a contemporary series of lung transplant recipients and describe their association with clinical outcomes.
  
  
  METHODS
  The records of all lung transplant recipients from July 1, 2008, to June 30, 2013, were reviewed and analyzed. DVT was diagnosed by venous duplex ultrasonography. PE was diagnosed by computed tomography angiography, nuclear ventilation/perfusion scanning, or pulmonary angiography.
  
  
  RESULTS
  The study comprised 117 patients who underwent 123 transplants. The median age was 63 years (range, 17 to 77 years). Forty-five patients (39%) had evidence of lower extremity DVT, 53 (45%) had no evidence of lower extremity DVT, and 19 (16%) were not tested. Fifty-three (45%) had evidence of upper extremity DVT, 30 (26%) had no evidence of upper extremity DVT, and 34 (29%) were not tested. Eighteen (15%) had evidence of PE, 82 (70%) had no evidence of PE, and 17 (15%) were not tested. A multivariable, stepwise Cox proportional hazards model revealed that the presence of lower extremity DVT (hazard ratio, 2.43; 95% confidence interval, 1.29 to 4.64), use of cardiopulmonary bypass (hazard ratio, 2.21; 95% confidence interval, 1.04 to 4.68), and unilateral lung transplantation (hazard ratio, 2.13; 95% confidence interval, 1.07 to 4.25) were associated with diminished survival.
  
  
  CONCLUSIONS
  The incidence of DVT and PE in lung transplant recipients is high. Posttransplant surveillance and treatment based on findings are warranted.
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Charles F
authors.initials: CF
authors.lastname: Evans
authors.affiliation: Pulmonary and Critical Care Medicine, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Aldo T
authors.initials: AT
authors.lastname: Iacono
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Pablo G
authors.initials: PG
authors.lastname: Sanchez
authors.affiliation: Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Olga
authors.initials: O
authors.lastname: Goloubeva
authors.affiliation: Division of Pulmonary and Critical Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: June
authors.initials: J
authors.lastname: Kim
authors.affiliation: Division of Pulmonary and Critical Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Irina
authors.initials: I
authors.lastname: Timofte
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Faisal H
authors.initials: FH
authors.lastname: Cheema
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Si M
authors.initials: SM
authors.lastname: Pham
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Bartley P
authors.initials: BP
authors.lastname: Griffith
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, The University of Texas Medical School at Houston, Houston, Texas. Electronic address: keshava.rajagopal@uth.tmc.edu.
authors.forename: Keshava
authors.initials: K
authors.lastname: Rajagopal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D018616:Ultrasonography, Doppler, Duplex; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult