Low potassium dextran is superior to University of Wisconsin solution in high-risk lung transplant recipients.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
George J ArnaoutakisAshish S Shah

Abstract

The ideal solution for recovery of donor lungs remains unknown. Low potassium dextran (LPD) solution is most common, but University of Wisconsin (UW) solution is also used. The United Network for Organ Sharing (UNOS) database allows assessment of preservation solutions in a large cohort of lung transplant (LTx) patients. We retrospectively reviewed the UNOS data set for adult primary LTx patients (2005-2008) whose donor lungs were recovered with UW or LPD solution. Patients were stratified by UW vs LPD, and secondarily grouped by quartiles of the lung allocation score (LAS) to examine high-risk recipients. Kaplan-Meier (KM) short-term mortality (30 days, 90 days, 1 year) and rejection in the first year were examined for intervals with adequate follow-up. Cox proportional hazard regression using 11 variables examined all cause 1-year mortality. Of 4,455 patients, 4,161 (93.4%) received LPD lungs and 294 (6.6%) received UW lungs, and 1,105 patients (24.8%) died during the study. There was no mortality difference based on flush solution with all patients examined together. However, patients in the upper 2 LAS quartiles (Q3: 37.8-45.4, Q4: > 45.4) receiving LPD lungs had greater 1-year survival of 81.5% vs 73.5% (p = 0.02). On mult...Continue Reading

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Citations

Jan 17, 2014·The Lancet. Respiratory Medicine·Laveena MunshiMarcelo Cypel
Sep 4, 2008·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·David F StoweDavid R Harder
May 21, 2015·Revista do Colégio Brasileiro de Cirurgiões·Jorge Miguel Schettino CésarAmanda Lima de Oliveira

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