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Evaluation of early graft function in a case series of lung-transplanted patients


The aim of the study was to investigate early graft function in terms of biological and radiological variables in a case series of lung transplant (Ltx).


We performed a prospective analysis of patients that underwent Ltx at Fondazione IRCCS Ca Granda Policlinico of Milan from 1 December 2012 to 10 December 2013. Donors' lung parameters were recorded. Recipients' clinical data were collected daily and lung computed tomography (CT) at end expiration was performed within 7 days after Ltx. On the same day, bronchoalveolar lavage was collected [1]. Quantitative CT analysis was run on separate lungs for each patient.

Table 1 Quantitative CT scan analysis on transplanted lungs


Out of 25 LTx, 12 paired data for donors and recipients were analyzed. Lung donors' PaO2/FiO2 was 392 ± 118, Oto score was 5 ± 3, and ICU length of stay was 2 ± 1 days. Recipients' age was 56 ± 11 years, and body mass index was 24 ± 4 kg/m2. Four patients received double Ltx, and the warm ischemia time was 85 ± 16 and 94 ± 14 respectively for right lung and left lung. When the CT scan was performed (on day 4 ± 1), four patients were mechanically ventilated, PaO2/FiO2 was 270 ± 93 and PaCO2 was 44.6 ± 10.0 mmHg. Primary graft dysfunction grade 2 or 3 at 72 hours post Ltx was diagnosed in six patients. All patients were discharged from ICU. Table 1 presents quantitative analysis of transplanted lungs. The alveolar protein concentration and not aerated tissue weight are significantly related (R2 = 0.69; P = 0.001).


Alveolar protein concentration is related to morphological features of lungs early after Ltx.


  1. Matute-Bello G, Liles WC, Radella F, Steinberg KP, Ruzinski JT, Jonas M, Chi EY, Hudson LD, Martin TR, et al.: Neutrophil apoptosis in the acute respiratory distress syndrome. Am J Respir Crit Care Med 1997, 156: 1969-1977.

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Fumagalli, J., Algieri, I., Brioni, M. et al. Evaluation of early graft function in a case series of lung-transplanted patients. Crit Care 18 (Suppl 1), P252 (2014).

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