- Email: [email protected]
97: Impact of Pre-Transplant Recipient Obesity on Outcomes after Lung Transplantation
The Journal of Heart and Lung Transplantation Volume 28, Number 2S
Conclusions: -atrial fibrillation wasn’t significant death risk factor among patients waiting for HT -heart rate ⬎ 90/min connects with worse prognosis in patients waiting for HF.
96 Previous Cardiovascular Disease or Diabetes Are Associated with a Very High Risk of Cardiovascular Disease after Lung Transplantation L. Plantier1, S. Neji1, G. Biondi1, G. Jebrak1, D. Himbert2, Y. Castier3, H. Mal1, G. Thabut1, M. Fournier1 1Ho ˆ pital Bichat, Paris, France; 2Ho ˆ pital Bichat, Paris, France; 3Ho ˆ pital Bichat, Paris, France Purpose: The impact of previous cardiovascular disease or risk factors on the outcome of lung transplantation may be important. Methods and Materials: Age, sex, medical and smoking history, cholesterol and triglyceride levels, electrocardiogram, echocardiography, right and left heart catheterisation, isotopic ventriculography and vascular ultrasonography data were obtained for 239 patients who underwent lung transplantation at our centre between 1988 and 2007. The effect of those parameters on survival and the occurence of cardiovascular disease after transplantation was determined with the Cox model. Results: The median age of patients was 53 years at the time of transplantation and most had emphysema or idiopathic pulmonary fibrosis. By multivariate analysis, diabetes (Hazard Ratio - HR: 2.4), elevated systolic pulmonary artery pressure (HR: 1.27 per 10 mmHg) and a low cardiac index (HR: 1.5 per l/min/m2) were associated with a higher instant risk of death after transplantation. A history of atherothrombosis events, defined as either ischemic stroke, coronary heart disease or peripheral vascular disease, was associated with a higher instant risk of atherothrombosis events after transplantation (HR: 13), as was diabetes (HR: 5.8). Conclusions: Diabetes, pulmonary hypertension and a low cardiac index before lung transplantation were associated with excess mortality after transplantation. Diabetes and a history of atherothrombosis were associated with a very high risk of cardiovascular events after transplantation.
Abstracts
S99
Purpose: Data from the International Registry suggest that pretransplant recipient obesity can lead to worse outcomes after lung transplantation. However, few obese patients have been transplanted and most centers have been very restrictive. We report our experience after consistently accepting obese patients for lung transplantation. Methods and Materials: Patients trasnsplanted from 5/4/05 to 7/31/08 were included. Demographic data, pre-transplant body mass index (BMI), pre-transplant diagnosis and post-transplant outcomes were collected. Patients with BMI over 30 were included in the obese group. Survival analysis was performed by using the Kaplan-Meier method and groups were compared by the log-rank test. Multivariable analysis was performed by Cox proportional hazards. Results: 45/181 (24.9%) of patients were obese. Obese patients were older (57.0⫾7.2 vs. 54.0⫾10.8; p⫽0.033) and had higher Lung Allocation Score (LAS) at the time of transplant (47.5⫾15.6 vs. 42.5⫾13.8; p⫽0.042). Gender and race distribution and performance of single vs. double lung transplant were similar between the groups. The BMIs for the obese vs. the non-obese groups were 32.4⫾2.0 vs. 23.9⫾3.4 respectively (p⬍0.001). However, survival between obese and non-obese patients was similar as can be seen in the figure (obese vs. non-obese: 1-year 88.4% vs. 79.7%; 3-year 65.7% vs. 68.8%; p⫽0.989). Results were similar when analyses were limited to patients with chronic obstructive pulmonary disease or idiopathic pulmonary fibrosis only and when patients with low BMI were excluded. Multivariable analysis revealed that BMI had no effect on survival, even after adjustment for LAS, diagnosis, type of transplant and other demographic variables. Conclusions: In this single center study obese patients had similar survival to non-obese patients despite being older and having higher LAS scores. Future studies will focus on whether obese patients have similar morbidity to non-obese patients and whether these outcomes can be reproduced in most transplant centers.
98
97
Efficacy of Dobutamine Stress Echocardiography in Cardiac Evaluation for Lung Transplantation S.M. Lome1, F.F. Jeff1, F. Ling2, D.F. Dilling2, R.B. Love1, C.H. Wigfield3, J.P. Gagermeier3, C.G. Alex, R.S. Dieter, F. Leya 1 Loyola University Chicago, Maywood, IL; 2Loyola University Chicago, Maywood, IL; 3Loyola University Chicago, Maywood, IL
Impact of Pre-Transplant Recipient Obesity on Outcomes after Lung Transplantation D. Hadjiliadis, N.P. Blumenthal, J. Mendez, K. Carney, D. Isaia, R. Lingaraju, J. Lee, R.M. Kotloff, J.D. Christie, V.N. Ahya, A. Pochettino University of Pennsylvania, Philadelphia, PA
Purpose: The optimal strategy for screening for significant coronary artery disease (CAD) in the evaluation for potential lung transplantation is not established. Methods and Materials: A retrospective chart review of patients aged 40 and over who underwent evaluation for potential lung
Conclusions: -atrial fibrillation wasn’t significant death risk factor among patients waiting for HT -heart rate ⬎ 90/min connects with worse prognosis in patients waiting for HF.
96 Previous Cardiovascular Disease or Diabetes Are Associated with a Very High Risk of Cardiovascular Disease after Lung Transplantation L. Plantier1, S. Neji1, G. Biondi1, G. Jebrak1, D. Himbert2, Y. Castier3, H. Mal1, G. Thabut1, M. Fournier1 1Ho ˆ pital Bichat, Paris, France; 2Ho ˆ pital Bichat, Paris, France; 3Ho ˆ pital Bichat, Paris, France Purpose: The impact of previous cardiovascular disease or risk factors on the outcome of lung transplantation may be important. Methods and Materials: Age, sex, medical and smoking history, cholesterol and triglyceride levels, electrocardiogram, echocardiography, right and left heart catheterisation, isotopic ventriculography and vascular ultrasonography data were obtained for 239 patients who underwent lung transplantation at our centre between 1988 and 2007. The effect of those parameters on survival and the occurence of cardiovascular disease after transplantation was determined with the Cox model. Results: The median age of patients was 53 years at the time of transplantation and most had emphysema or idiopathic pulmonary fibrosis. By multivariate analysis, diabetes (Hazard Ratio - HR: 2.4), elevated systolic pulmonary artery pressure (HR: 1.27 per 10 mmHg) and a low cardiac index (HR: 1.5 per l/min/m2) were associated with a higher instant risk of death after transplantation. A history of atherothrombosis events, defined as either ischemic stroke, coronary heart disease or peripheral vascular disease, was associated with a higher instant risk of atherothrombosis events after transplantation (HR: 13), as was diabetes (HR: 5.8). Conclusions: Diabetes, pulmonary hypertension and a low cardiac index before lung transplantation were associated with excess mortality after transplantation. Diabetes and a history of atherothrombosis were associated with a very high risk of cardiovascular events after transplantation.
Abstracts
S99
Purpose: Data from the International Registry suggest that pretransplant recipient obesity can lead to worse outcomes after lung transplantation. However, few obese patients have been transplanted and most centers have been very restrictive. We report our experience after consistently accepting obese patients for lung transplantation. Methods and Materials: Patients trasnsplanted from 5/4/05 to 7/31/08 were included. Demographic data, pre-transplant body mass index (BMI), pre-transplant diagnosis and post-transplant outcomes were collected. Patients with BMI over 30 were included in the obese group. Survival analysis was performed by using the Kaplan-Meier method and groups were compared by the log-rank test. Multivariable analysis was performed by Cox proportional hazards. Results: 45/181 (24.9%) of patients were obese. Obese patients were older (57.0⫾7.2 vs. 54.0⫾10.8; p⫽0.033) and had higher Lung Allocation Score (LAS) at the time of transplant (47.5⫾15.6 vs. 42.5⫾13.8; p⫽0.042). Gender and race distribution and performance of single vs. double lung transplant were similar between the groups. The BMIs for the obese vs. the non-obese groups were 32.4⫾2.0 vs. 23.9⫾3.4 respectively (p⬍0.001). However, survival between obese and non-obese patients was similar as can be seen in the figure (obese vs. non-obese: 1-year 88.4% vs. 79.7%; 3-year 65.7% vs. 68.8%; p⫽0.989). Results were similar when analyses were limited to patients with chronic obstructive pulmonary disease or idiopathic pulmonary fibrosis only and when patients with low BMI were excluded. Multivariable analysis revealed that BMI had no effect on survival, even after adjustment for LAS, diagnosis, type of transplant and other demographic variables. Conclusions: In this single center study obese patients had similar survival to non-obese patients despite being older and having higher LAS scores. Future studies will focus on whether obese patients have similar morbidity to non-obese patients and whether these outcomes can be reproduced in most transplant centers.
98
97
Efficacy of Dobutamine Stress Echocardiography in Cardiac Evaluation for Lung Transplantation S.M. Lome1, F.F. Jeff1, F. Ling2, D.F. Dilling2, R.B. Love1, C.H. Wigfield3, J.P. Gagermeier3, C.G. Alex, R.S. Dieter, F. Leya 1 Loyola University Chicago, Maywood, IL; 2Loyola University Chicago, Maywood, IL; 3Loyola University Chicago, Maywood, IL
Impact of Pre-Transplant Recipient Obesity on Outcomes after Lung Transplantation D. Hadjiliadis, N.P. Blumenthal, J. Mendez, K. Carney, D. Isaia, R. Lingaraju, J. Lee, R.M. Kotloff, J.D. Christie, V.N. Ahya, A. Pochettino University of Pennsylvania, Philadelphia, PA
Purpose: The optimal strategy for screening for significant coronary artery disease (CAD) in the evaluation for potential lung transplantation is not established. Methods and Materials: A retrospective chart review of patients aged 40 and over who underwent evaluation for potential lung