• Julien Fessler, Matthieu Glorion, Michaël Finet, Claire Soniak, Sylvie Colin de Verdiere, Edouard Sage, Antoine Roux, Benjamin Zuber, Marc Fischler, GuenMorgan LeMLDepartment of Anesthesiology, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France., and Alexandre Vallée.
• Department of Anesthesiology, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France.
• J. Cardiothorac. Vasc. Anesth. 2023 Jun 1; 37 (6): 964971964-971.

ObjectiveLife expectancy for lung-transplant patients, especially those with cystic fibrosis (CF), is leading increasingly to more retransplantations.DesignRetrospective monocentric cohort study.SettingFoch University Hospital, Suresnes, France.ParticipantsCF patients having had a primary double-lung transplantation (pLgTx) or a retransplantation (reLgTx) from 2012 to 2021.InterventionsNone.Measurements And Main ResultsThe authors compared the main intraoperative and early postoperative features between pLgTx (n = 258) and reLgTx (n = 24). Demographic characteristics were similar. No patients with retransplantations had a preoperative bridge with extracorporeal membrane oxygenation (ECMO); however, 23 patients had it in the pLgTx group (p = 0.24). Patients with retransplants had longer second graft ischemic time (p = 0.02), larger intraoperative bleeding volume (p = 0.001) and blood transfusion (p = 0.009 for packed red blood cells), increased blood lactate concentrations (p = 0.002), and higher norepinephrine dose at end-surgery (p = 0.001). Extracorporeal membrane oxygenation was used during surgery in 94 patients in the pLgTx group and 12 patients in the reLgTx group (p = 0.39). Extracorporeal membrane oxygenation could not be weaned after surgery in 55 patients in the pLgTx group and 4 in the reLgTx group (p = 0.54). Despite worse preoperative renal function in the reLgTx group (p < 0.001), there was no difference concerning renal replacement therapy in the intensive care unit between groups (p = 0.08). There were no differences between groups concerning the main complications, including primary graft dysfunction. Although the difference was not statistically different (p = 0.17), mortality was 3 times higher in the reLgTx group.ConclusionsIntraoperative period of retransplantation was more convoluted but had a similar ECMO profile to primary transplantation. In addition, the early postoperative period was similar.Copyright © 2023 Elsevier Inc. All rights reserved.

12 keywords...

hide…