title: Effects of intraoperative inhaled iloprost on primary graft dysfunction after lung transplantation: A retrospective single center study.
abstract: METHODS
  Inhaled iloprost was known to alleviate ischemic-reperfusion lung injury. We investigated whether intraoperative inhaled iloprost can prevent the development of primary graft dysfunction after lung transplantation. Data for a consecutive series of patients who underwent lung transplantation with extracorporeal membrane oxygenation were retrieved. By propensity score matching, 2 comparable groups of 30 patients were obtained: patients who inhaled iloprost immediately after reperfusion of the grafted lung (ILO group); patients who did not receive iloprost (non-ILO group).
  
  
  RESULTS
  The severity of pulmonary infiltration on postoperative days (PODs) 1 to 3 was significantly lower in the ILO group compared to the non-ILO group. The PaO2/FiO2 ratio was significantly higher in the ILO group compared to the non-ILO group (318.2 ± 74.2 vs 275.9 ± 65.3 mm Hg, P = 0.022 on POD 1; 351.4 ± 58.2 vs 295.8 ± 53.7 mm Hg, P = 0.017 on POD 2; and 378.8 ± 51.9 vs 320.2 ± 66.2 mm Hg, P = 0.013 on POD 3, respectively). The prevalence of the primary graft dysfunction grade 3 was lower in the ILO group compared to the non-ILO group (P = 0.042 on POD 1; P = 0.026 on POD 2; P = 0.024 on POD 3, respectively). The duration of ventilator use and intensive care unit were significantly reduced in the ILO group (P = 0.041 and 0.038).
  
  
  CONCLUSIONS
  Intraoperative inhaled iloprost could prevent primary graft dysfunction and preserve allograft function, thus reducing the length of ventilator care and intensive care unit stay, and improving the overall early post-transplant morbidity in patients undergoing lung transplantation.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute Department of Thoracic and Cardiovascular Surgery Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Su Hyun
authors.initials: SH
authors.lastname: Lee
authors.forename: Jin Gu
authors.initials: JG
authors.lastname: Lee
authors.forename: Chang Yeong
authors.initials: CY
authors.lastname: Lee
authors.forename: Namo
authors.initials: N
authors.lastname: Kim
authors.forename: Min-Yung
authors.initials: MY
authors.lastname: Chang
authors.forename: Young-Chul
authors.initials: YC
authors.lastname: You
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Kim
authors.forename: Hyo Chae
authors.initials: HC
authors.lastname: Paik
authors.forename: Young Jun
authors.initials: YJ
authors.lastname: Oh
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D005260:Female; D006801:Humans; D016285:Iloprost / Q000008:administration & dosage*; D007430:Intraoperative Care; D016040:Lung Transplantation; D008297:Male; D055031:Primary Graft Dysfunction / Q000517:prevention & control*; D012189:Retrospective Studies; D014665:Vasodilator Agents / Q000008:administration & dosage*
chemical_list: D014665:Vasodilator Agents; D016285:Iloprost