Time on the waiting list is an independent risk factor for day-90 mortality after lung transplantation.
Enora Atchade, Vincent Bunel-Gourdy, Nathalie Zappella, Sylvain Jean-Baptiste, Alexy Tran-Dinh, S��bastien Tanaka, Brice Lortat-Jacob, Arnaud Roussel, Pierre Mordant, Yves Castier, Herv�� Mal, Christian De Tymowski, Philippe Montravers
Author Information
Enora Atchade: APHP, CHU Bichat-Claude Bernard, DMU PARABOL, 46 rue Henri Huchard, 75018 Paris, France; Inflammation Research Center, Inserm UMR 1149, Paris, France. Electronic address: enora.atchade@aphp.fr.
Vincent Bunel-Gourdy: APHP, CHU Bichat-Claude Bernard, Service de Pneumologie B et Transplantation Pulmonaire, 46 rue Henri Huchard, 75018 Paris, France.
Nathalie Zappella: APHP, CHU Bichat-Claude Bernard, DMU PARABOL, 46 rue Henri Huchard, 75018 Paris, France.
Sylvain Jean-Baptiste: APHP, CHU Bichat-Claude Bernard, DMU PARABOL, 46 rue Henri Huchard, 75018 Paris, France.
Alexy Tran-Dinh: APHP, CHU Bichat-Claude Bernard, DMU PARABOL, 46 rue Henri Huchard, 75018 Paris, France; INSERM U1148, LVTS, CHU Bichat-Claude Bernard, 46 rue Henri Huchard, 75018 Paris, France; Universit�� de Paris, UFR Diderot, France.
S��bastien Tanaka: APHP, CHU Bichat-Claude Bernard, DMU PARABOL, 46 rue Henri Huchard, 75018 Paris, France; Universit�� de la R��union, INSERM UMR 1188, Diab��te Ath��rothrombose R��union Oc��an Indien (D��TROI), Saint-Denis de la R��union, France.
Brice Lortat-Jacob: APHP, CHU Bichat-Claude Bernard, DMU PARABOL, 46 rue Henri Huchard, 75018 Paris, France.
Arnaud Roussel: APHP, CHU Bichat-Claude Bernard, Service de Chirurgie Thoracique et Vasculaire, 46 rue Henri Huchard, 75018 Paris, France.
Pierre Mordant: Universit�� de Paris, UFR Diderot, France; APHP, CHU Bichat-Claude Bernard, Service de Chirurgie Thoracique et Vasculaire, 46 rue Henri Huchard, 75018 Paris, France.
Yves Castier: Universit�� de Paris, UFR Diderot, France; APHP, CHU Bichat-Claude Bernard, Service de Chirurgie Thoracique et Vasculaire, 46 rue Henri Huchard, 75018 Paris, France; INSERM UMR 1152, Physiopathologie et Epid��miologie des maladies respiratoires, Paris, France.
Herv�� Mal: APHP, CHU Bichat-Claude Bernard, Service de Pneumologie B et Transplantation Pulmonaire, 46 rue Henri Huchard, 75018 Paris, France; Universit�� de Paris, UFR Diderot, France; INSERM UMR 1152, Physiopathologie et Epid��miologie des maladies respiratoires, Paris, France.
Christian De Tymowski: APHP, CHU Bichat-Claude Bernard, DMU PARABOL, 46 rue Henri Huchard, 75018 Paris, France; INSERM UMR 1149, Immunorecepteur et immunopathologie r��nale, CHU Bichat-Claude Bernard, 46 rue Henri Huchard, 75018 Paris, France.
Philippe Montravers: APHP, CHU Bichat-Claude Bernard, DMU PARABOL, 46 rue Henri Huchard, 75018 Paris, France; Universit�� de Paris, UFR Diderot, France; INSERM UMR 1152, Physiopathologie et Epid��miologie des maladies respiratoires, Paris, France.
BACKGROUND: The waitlist deaths of transplantation candidates based on their time on the waiting list (TWL) have already been studied, but the short-term mortality and early complications of lung transplant (LT) recipients based on their TWL have not been specifically studied. The first aim of this study was to assess the relationship between increased TWL and short-term mortality in LT recipients. METHODS: In this observational, monocentric, retrospective study, all patients who underwent LT between January 2016 and August 2022 at Bichat Claude Bernard Hospital, Paris were analyzed. Univariate analysis (chi2 test, Mann-Whitney test, Fisher's exact test) and multivariate analysis (logistic regression) were performed. Ninety-days and one-year survival were studied (Kaplan-Meier curves, log-rank test). p���<���0.05 indicated statistical significance. RESULTS: 242 LT patients were analyzed. The median TWL was 100 (43-229) days. Postoperative complications, including septic shock (36 versus 18%, p���=���0.002), grade 3 primary graft dysfunction (31 versus 20%, p���<���0.001), and KDIGO3 acute kidney injury (8 versus 25%, p���<���0.001), were more common in the prolonged TWL (pTWL) group (>100 days) than in the short TWL group (���100 days). The duration of hospitalization in the ICU was longer (18 [11-34] versus 13 [9-23] days, p���=���0.02) in the pTWL group. According to our multivariate analysis, TWL was an independent risk factor for 90-days mortality (OR 1.02, 95% CI [1.00-1.04]; p���=���0.032). CONCLUSION: TWL was an independent risk factor for 90-days mortality after LT. Receiving LT after more than 100 days on the waitlist exposes to increased postoperative complications.
