title: Impact of time interval between donor brain death and cold preservation on long-term outcome in lung transplantation.
abstract: OBJECTIVE
  Brain death (BD) is associated with various systemic responses and a cascade of inflammatory reactions. It is still unknown how the time interval from BD to cold preservation (CP) affects outcome after lung transplantation (LTx). This report investigates the impact of the time interval from BD to CP on long-term outcome in LTx.
  
  
  METHODS
  We reviewed 250 consecutive recipients who underwent LTx at our institution between January 2000 and December 2011. In Group I (n = 212), the time interval from BD to CP was <24 h, and in Group II (n = 38) >24 h. Cox proportional hazard regression analysis was performed to determine the risk factors affecting survival.
  
  
  RESULTS
  The median time from BD to CP was 18.6 h (range 9-65). The rate of postoperative complications was comparable (P = 0.8). The 30-day mortality rate was 7.5% in Group I and 0% in Group II. The 5-year survival rate was better in Group II [70% (95% CI: 48.5-83.8%)] than in Group I [66% (95% CI: 58.3-72.5%)] without statistical significance (P = 0.3). Intraoperative extracorporeal membrane oxygenation (ECMO) use was identified as a significant risk factor for survival [HR = 1.7, (95% CI: 1.1-2.6), P = 0.01].
  
  
  CONCLUSIONS
  In our cohort, the time interval from BD to CP had no impact on long-term outcome after LTx.
authors.affiliation: Department of Thoracic Surgery, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Ylenia
authors.initials: Y
authors.lastname: Pecoraro
authors.affiliation: Department of Thoracic Surgery, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Tsushima
authors.affiliation: Department of Thoracic Surgery, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Opitz
authors.affiliation: Division of Pulmonary Medicine, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Benden
authors.affiliation: Division of Surgical Intensive Care, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Reto
authors.initials: R
authors.lastname: Schüpbach
authors.affiliation: Division of Surgical Intensive Care, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Renato
authors.initials: R
authors.lastname: Lenherr
authors.affiliation: Department of Thoracic Surgery, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Jungraithmayr
authors.affiliation: Department of Thoracic Surgery, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Walter
authors.initials: W
authors.lastname: Weder
authors.affiliation: Department of Thoracic Surgery, Zurich University Hospital, Zurich, Switzerland ilhan.inci@usz.ch.
authors.forename: Ilhan
authors.initials: I
authors.lastname: Inci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001926:Brain Death; D015925:Cryopreservation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D016040:Lung Transplantation / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012131:Respiratory Insufficiency / Q000401:mortality / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013557:Switzerland / Q000453:epidemiology; D013997:Time Factors; D061665:Time-to-Treatment; D014019:Tissue Donors; D055815:Young Adult
keywords: Brain death; Cold ischaemic time; Cold preservation; Lung transplantation; Outcome; Survival