PMID- 12042650
OWN - NLM
STAT- MEDLINE
DCOM- 20020626
LR  - 20190713
IS  - 0041-1337 (Print)
IS  - 0041-1337 (Linking)
VI  - 73
IP  - 10
DP  - 2002 May 27
TI  - Survival benefit of cardiopulmonary bypass support in bilateral lung 
      transplantation for emphysema patients.
PG  - 1621-7
AB  - BACKGROUND: This study is designed to examine a possible association of 
      cardiopulmonary bypass (CPB) support and outcome of lung transplantation in a 
      well-balanced group of emphysema patients. METHODS: We performed a retrospective 
      analysis of 62 consecutive primary bilateral lung transplantations for emphysema. 
      Risk factors for their possible association with patient survival were analyzed 
      by multivariate logistic regression. RESULTS: The use of CPB support was 
      associated with improved survival (odds ratio=0.25; P=0.038). The actuarial 
      survival at 1 year was 97% for patients treated with CPB and 77% for patients 
      treated without CPB support. In 28 patients (45%), 2 human leukocyte antigen 
      (HLA)-DR mismatches between donor and recipient occurred, whereas 34 patients had 
      0 or 1 HLA-DR mismatches. The use of CPB support in the group with two HLA-DR 
      mismatches was associated with improved survival (odds ratio=0.06; P=0.020). This 
      association was not present in the group with 0 or 1 HLA-DR mismatches. 
      CONCLUSIONS: These results demonstrate a significant survival benefit of CPB 
      support during bilateral lung transplantation in emphysema patients. The 
      difference in survival benefit of CPB support between the patients with 0 or 1 
      HLA-DR mismatches and the patients with 2 HLA-DR mismatches indicates that the 
      immunosuppressive effect of CPB support might be responsible for this survival 
      benefit. The underlying immunological mechanism might be important in the future 
      treatment of organ transplantation.
FAU - de Boer, Willem J
AU  - de Boer WJ
AD  - Department of Cardiothoracic Surgery, University Hospital Groningen, 9700 RB 
      Groningen, The Netherlands. W.J.de.Boer@ thorax.azg.nl
FAU - Hepkema, Bouke G
AU  - Hepkema BG
FAU - Loef, Bert G
AU  - Loef BG
FAU - van der Bij, Wim
AU  - van der Bij W
FAU - Verschuuren, Erik A M
AU  - Verschuuren EA
FAU - de Vries, Hans J
AU  - de Vries HJ
FAU - Lems, Simon P M
AU  - Lems SP
FAU - Ebels, Tjark
AU  - Ebels T
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
SB  - IM
MH  - *Cardiopulmonary Bypass
MH  - Disease-Free Survival
MH  - Emphysema/*surgery
MH  - Humans
MH  - *Intraoperative Care
MH  - Lung Transplantation/mortality/*physiology
MH  - Middle Aged
MH  - Odds Ratio
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Rate
MH  - Time Factors
MH  - Treatment Outcome
MH  - Waiting Lists
EDAT- 2002/06/04 10:00
MHDA- 2002/06/27 10:01
CRDT- 2002/06/04 10:00
PHST- 2002/06/04 10:00 [pubmed]
PHST- 2002/06/27 10:01 [medline]
PHST- 2002/06/04 10:00 [entrez]
AID - 10.1097/00007890-200205270-00017 [doi]
PST - ppublish
SO  - Transplantation. 2002 May 27;73(10):1621-7. doi: 
      10.1097/00007890-200205270-00017.