The implications of pulmonary embolism in a multiorgan donor for subsequent pulmonary, renal, and cardiac transplantation

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
Takahiro OtoGregory I Snell

Abstract

Unexpected donor pulmonary embolism is suggested to be associated with primary graft dysfunction (PGD) after lung transplantation. In multiorgan donors with pulmonary embolism, multiple organs could potentially be at high risk for the development of post-transplant PGD. This study investigated (1) the association of donor pulmonary embolism with different organ transplant outcomes where a recipient received an organ (heart or kidney) from a lung donor, (2) the effect of different composition of pulmonary embolism (fat or thromboemboli) on multiorgan post-transplant PGD, and (3) the effect of removal of pulmonary embolism (therapeutic flush) on lung transplant outcomes. The study included 130 multiorgan donors and 135 lung, 38 heart, and 172 kidney transplant recipients. Pulmonary embolism was detected in 40 of 130 (31%) multiorgan donors (10 fat emboli, 30 thromboemboli). A significant association between donor pulmonary embolism and PGD was seen in lung, but not in heart and kidney transplant recipients. A multivariate analysis showed that lung transplant recipients receiving lungs with fat emboli and thromboemboli were 20.6-fold (p = 0.0002) and 4.8-fold (p = 0.02) more likely to develop severe PGD, respectively, compared wit...Continue Reading

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Citations

Nov 13, 2008·General Thoracic and Cardiovascular Surgery·Takahiro Oto
Jan 31, 2012·Expert Review of Respiratory Medicine·Marcelo Cypel, Shaf Keshavjee
Apr 23, 2011·Clinics in Chest Medicine·Gregory I Snell, Glen P Westall
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Nov 14, 2019·General Thoracic and Cardiovascular Surgery·Masahiro IrieShinichi Toyooka
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Jun 15, 2021·Indian Journal of Thoracic and Cardiovascular Surgery : Official Organ, Association of Thoracic and Cardiovascular Surgeons of India·Vanessa SoetantoHarpreet Singh Grewal

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