Original Articles: General ThoracicEffect of ischemic time on survival in clinical lung transplantation
Section snippets
Patients and methods
Between April 1988 and June 1998, 392 patients underwent first-time single or double-lung transplantation. Four recipients of living-related grafts were excluded. Recipient ages ranged from 9 to 68 years, with a median of 45 years. There were 217 women and 175 men.
Results
Ischemic time data were available for 352 of 392 (90%) patients. Ischemic times ranged from 65 to 538 minutes, with a median value of 289 minutes. Ischemic times were grouped as follows: 0 to 4 hours (n = 91), 4 to 6 hours (n = 201), more than 6 hours (n = 60). Actuarial survival was similar among the three groups (Fig 1). Mean follow-up for each of the three ischemic time groups was 3.5, 3.6, and 4.0 years (0 to 4 hours, 4 to 6 hours, > 6 hours, respectively, p = 0.51). There was no
Comment
Ischemic time exerts a strong influence on graft survival in cardiac transplantation. Opelz and associates demonstrated an 8% greater survival 3 years posttransplantation for hearts with ischemic times less than 4 hours, in comparison with those having ischemic times exceeding 4 hours [1]. The International Society for Heart and Lung Transplantation’s registry includes data on over 45,000 heart transplants, and clearly demonstrates a highly significant, stepwise negative effect of increasing
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