Pleural effusions requiring thoracocentesis are associated with baseline lung allograft dysfunction and mortality in lung transplant recipients

Résumé fourni par la source

Background: Pleural effusions of unknown etiology in lung allograft recipients are associated with poor prognosis. This study sought to identify novel risk factors for pleural effusions after lung transplantation and investigate their association with allograft function and survival, differentiating early and late pleural effusions after lung transplantation. Methods: A retrospective study of all LTX recipients transplanted at the LMU Klinikum Munich from 2013 to 2018 was performed. All pleural effusions requiring thoracocentesis were recorded and analyzed corresponding clinical data. Results: A total of 426 pleural effusions in 369 lung allograft recipients with a median follow-up time of 6.9 years were analyzed. Early (< 90 days after LTX) and late pleural effusions (> 90 days after LTX) were associated with increased mortality. Early pleural effusions were also associated with a higher risk for baseline lung allograft dysfunction (BLAD), however no association with chronic lung allograft dysfunction was found. Early pleural effusions were associated with underlying obstructive disease, relative donor organ undersizing and clamshell thoracotomy. Notably, (partial) resection of the parietal pleura during lung transplantation was not associated with pleural effusions. Conclusions: This study underlines the significance of pleural effusions after lung transplantation. All pleural effusions were associated with increased mortality, while early pleural effusions also were associated with BLAD. The mechanisms linking pleural effusions to BLAD and to higher mortality will be subject to future studies.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.