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04-08-2023 | Original Article

Impact of perioperative airway pathogens on living-donor lobar lung transplantation outcomes

Authors: Hiromi Oda, Satona Tanaka, Toyofumi F. Chen-Yoshikawa, Yuki Morimura, Yoshito Yamada, Yojiro Yutaka, Daisuke Nakajima, Masatsugu Hamaji, Akihiro Ohsumi, Toshi Menju, Miki Nagao, Hiroshi Date

Published in: Surgery Today | Issue 3/2024

Abstract

Purpose

To elucidate the clinical impact of pathogenic organism (PO) positivity early after transplantation, we evaluated the impact of perioperative airway POs on outcomes after living-donor lobar lung transplantation (LDLLT), where the graft airway is supposed to be sterile from a healthy donor.

Method

A retrospective review of 67 adult LDLLT procedures involving 132 living donors was performed. Presence of POs in the recipients’ airways was evaluated preoperatively and postoperatively in intensive-care units.

Results

POs were detected preoperatively in 13 (19.4%) recipients. No POs were isolated from the donor airways at transplantation. POs were detected in 39 (58.2%) recipients postoperatively; most were different from the POs isolated preoperatively. Postoperative PO isolation was not associated with short-term outcomes other than prolonged postoperative ventilation. The 5-year overall survival was significantly better in the PO-negative group than in the PO-positive group (89.1% vs. 63.7%, P = 0.014). In the multivariate analysis, advanced age (hazard ratio [HR]: 1.041 per 1-year increase, P = 0.033) and posttransplant PO positivity in the airway (HR: 3.684, P = 0.019) significantly affected the survival.

Conclusions

The airways of the living-donor grafts were microbiologically sterile. PO positivity in the airway early after transplantation negatively impacted long-term outcomes.

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Title: Impact of perioperative airway pathogens on living-donor lobar lung transplantation outcomes
Authors: Hiromi Oda
Satona Tanaka
Toyofumi F. Chen-Yoshikawa
Yuki Morimura
Yoshito Yamada
Yojiro Yutaka
Daisuke Nakajima
Masatsugu Hamaji
Akihiro Ohsumi
Toshi Menju
Miki Nagao
Hiroshi Date
Publication date: 04-08-2023
Publisher: Springer Nature Singapore
Published in: Surgery Today / Issue 3/2024
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-023-02730-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of perioperative airway pathogens on living-donor lobar lung transplantation outcomes

Abstract

Purpose

Method

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Method

Results

Conclusions

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