Risk Factors of Delayed Catastrophic Intra-Abdominal Complication after Lung Transplant: A Review of the UNOS Database

J. P. Skendelas, D. Chauhan, J. J. Lee, H. Seethamraju, S. A. Scheinin, S. J. Forest

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: Catastrophic intra-abdominal complications (IAC), often requiring emergent surgery or leading to mortality, are common among the lung transplant population. We sought to identify risk factors associated with death secondary to IAC following lung transplantation. METHODS: The United Network for Organ Sharing (UNOS) database was reviewed for all adult patients (≥18 years) who underwent lung transplantation. All patients who died of IAC were identified and compared to all other recipients as the control (CON) cohort. Patients with survival ≤3 months or death during index hospitalization were consider perioperative deaths and excluded. Univariate analysis was performed to identify factors associated with death from IAC. RESULTS: Between 2005 and 2013, 13276 isolated single and double lung transplants were identified. The IAC cohort was comprised of 109 patients. 12332 (92.9%) recipients survived to 3 months and 83 (0.7%) suffered an IAC. Recipients in the IAC cohort were older 62.0 (IQR=11.0) vs 59.0 yrs (IQR 15.0) and most likely to be diagnosed with COPD, 29 (34.9%). The most common etiology of IAC was secondary to C. difficile, 18 (21.7%). Gender, etiology of lung failure, and ischemia time were similar between the two cohorts. Overall, IAC patients had a longer length of stay (LOS), 22.0 (IQR=28.0) compared to 15.0 (IQR=14.0) days (p =0.012). This trend in LOS did not persist in single lung recipients, IAC 14.0 (IQR=16.0) vs 13.0 (10.0) days (p=0.259). Remaining comparative demographics and univariate analyses are included in Table 1. CONCLUSION: Catastrophic IAC remain a challenging complication following lung transplantation. Increased length of stay on index hospitalization and similarly, C. difficile infection, were associated with the development of IAC related deaths following lung transplantation.

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

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