Early laparotomy after lung transplantation: Increased incidence for patients with α1-anti-trypsin deficiency
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Early laparotomy after lung transplantation : Increased incidence for patients with α1-anti-trypsin deficiency. / Bredahl, Pia; Zemtsovski, Mikhail; Perch, Michael; Pedersen, Dorte Levin; Rasmussen, Allan; Steinbrüchel, Daniel; Carlsen, Jørn; Iversen, Martin.
I: Journal of Heart and Lung Transplantation, Bind 33, Nr. 7, 07.2014, s. 727-733.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Early laparotomy after lung transplantation
T2 - Increased incidence for patients with α1-anti-trypsin deficiency
AU - Bredahl, Pia
AU - Zemtsovski, Mikhail
AU - Perch, Michael
AU - Pedersen, Dorte Levin
AU - Rasmussen, Allan
AU - Steinbrüchel, Daniel
AU - Carlsen, Jørn
AU - Iversen, Martin
N1 - Copyright © 2014 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
PY - 2014/7
Y1 - 2014/7
N2 - BACKGROUND: Gastrointestinal complications after lung transplantation have been reported with incidence rates ranging from 3% to 51%, but the reasons are poorly understood. We aimed to investigate the correlations between pulmonary diseases leading to lung transplantation and early gastrointestinal complications requiring laparotomy after transplantation with outcomes for patients at increased risk.METHODS: In this study we performed a retrospective analysis of data of patients who underwent lung transplantation at our institution from 2004 to 2012. The study period was limited to the first 90 days after transplantation.RESULTS: Lung transplantation was performed in 258 patients, including 51 patients with α1-anti-trypsin deficiency (A1AD). Seventy-eight patients (30%) had an X-ray of the abdomen, and 23 patients (9%) required laparotomy during the first 90 days after transplantation. Patients with A1AD comprised 20% of the total recipients, 23% (18 of 78) of the patients who had an abdominal X-ray performed (p = 0.40), and 48% (11 of 23) of the patients who required laparotomy (p < 0.001). More than 1 of every 5 patients (11 of 51) with A1AD required laparotomy at a median 8 days after transplantation, and the estimated odds ratio for laparotomy for A1AD patients was 5.74 (CI 2.15 to 15.35). In the group of patients with A1AD who required laparotomy, the estimated hazard ratio for death was 1.62 (CI 0.57 to 4.62), the stay in the intensive care unit was prolonged, but no significant difference was observed for time on mechanical ventilation. Among pulmonary diseases and demographics of the patients, no other risk factors were identified for laparotomy.CONCLUSIONS: A1AD was the only significant risk factor identified for gastrointestinal complications that required laparotomy within 3 months after lung transplantation. There was a trend toward a higher risk of death after laparotomy in patients with A1AD, and the length of stay in the intensive care unit was significantly prolonged, whereas the time on mechanical ventilation was unaffected.
AB - BACKGROUND: Gastrointestinal complications after lung transplantation have been reported with incidence rates ranging from 3% to 51%, but the reasons are poorly understood. We aimed to investigate the correlations between pulmonary diseases leading to lung transplantation and early gastrointestinal complications requiring laparotomy after transplantation with outcomes for patients at increased risk.METHODS: In this study we performed a retrospective analysis of data of patients who underwent lung transplantation at our institution from 2004 to 2012. The study period was limited to the first 90 days after transplantation.RESULTS: Lung transplantation was performed in 258 patients, including 51 patients with α1-anti-trypsin deficiency (A1AD). Seventy-eight patients (30%) had an X-ray of the abdomen, and 23 patients (9%) required laparotomy during the first 90 days after transplantation. Patients with A1AD comprised 20% of the total recipients, 23% (18 of 78) of the patients who had an abdominal X-ray performed (p = 0.40), and 48% (11 of 23) of the patients who required laparotomy (p < 0.001). More than 1 of every 5 patients (11 of 51) with A1AD required laparotomy at a median 8 days after transplantation, and the estimated odds ratio for laparotomy for A1AD patients was 5.74 (CI 2.15 to 15.35). In the group of patients with A1AD who required laparotomy, the estimated hazard ratio for death was 1.62 (CI 0.57 to 4.62), the stay in the intensive care unit was prolonged, but no significant difference was observed for time on mechanical ventilation. Among pulmonary diseases and demographics of the patients, no other risk factors were identified for laparotomy.CONCLUSIONS: A1AD was the only significant risk factor identified for gastrointestinal complications that required laparotomy within 3 months after lung transplantation. There was a trend toward a higher risk of death after laparotomy in patients with A1AD, and the length of stay in the intensive care unit was significantly prolonged, whereas the time on mechanical ventilation was unaffected.
KW - Adolescent
KW - Adult
KW - Child
KW - Female
KW - Gastrointestinal Diseases
KW - Humans
KW - Incidence
KW - Intensive Care Units
KW - Laparotomy
KW - Length of Stay
KW - Lung Transplantation
KW - Male
KW - Middle Aged
KW - Postoperative Complications
KW - Pulmonary Emphysema
KW - Retrospective Studies
KW - Risk Factors
KW - Time Factors
KW - Treatment Outcome
KW - Young Adult
KW - alpha 1-Antitrypsin Deficiency
U2 - 10.1016/j.healun.2014.02.025
DO - 10.1016/j.healun.2014.02.025
M3 - Journal article
C2 - 24709270
VL - 33
SP - 727
EP - 733
JO - Journal of Heart and Lung Transplantation
JF - Journal of Heart and Lung Transplantation
SN - 1053-2498
IS - 7
ER -
ID: 138613418