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• W4254600513 abstract "Lung transplantation (LT) for pulmonary fibrosis is related to higher mortality than other transplant indications. We aim to assess whether the amount of anterior mediastinal fat (AMF) was associated to early and long-term outcomes in fibrotic patients undergoing LT.Retrospective analysis of 92 consecutive single lung transplants (SLT) for pulmonary fibrosis over a 10-year period. AMF dimensions were measured on preoperative CT-scan: anteroposterior axis (AP), transverse axis (T), and height (H). AMF volumes (V) were calculated by the formula: AP × T × H × 3.14/6.According to the radiological AMF dimensions, patients were distributed into two groups: low-AMF (V < 20 cm3) and high-AMF (V > 20 cm3), and early and long-term outcomes were compared by univariable and multivariable analyses.There were 92 SLT: 73M/19F, 53 ± 11 [14–68] years old. 30-Day mortality (low-AMF vs. high-AMF): 5 (5.4%) vs. 15 (16.3%), p = 0.014. Patients developing primary graft dysfunction within 72 h post-transplant, and those dying within 30 days post-transplant presented higher AMF volumes: 21.1 ± 19.8 vs. 43.3 ± 24.7 cm3 (p = 0.03) and 24.4 ± 24.2 vs. 56.9 ± 63.6 cm3 (p < 0.01) respectively. Overall survival (low-AMF vs. high-AMF) (1, 3, and 5 years): 85%, 81%, 78% vs. 55%, 40%, 33% (p < 0.001).Factors predicting 30-day mortality were: BMI (HR = 0.77, p = 0.011), AMF volume (HR = 1.04, p = 0.018), CPB (HR = 1.42, p = 0.002), ischaemic time (HR = 1.01, p = 0.009).Factors predicting survival were: AMF volume (HR = 1.02, p < 0.001), CPB (HR = 3.17, p = 0.003), ischaemic time (HR = 1.01, p = 0.001).Preoperative radiological assessment of mediastinal fat dimensions and volumes may be a useful tool to identify fibrotic patients at higher risk of mortality after single lung transplantation.El trasplante de pulmón (TP) para el tratamiento de la fibrosis pulmonar está relacionado con una mayor mortalidad que otras indicaciones de trasplante. Nuestro objetivo es evaluar si la cantidad de grasa mediastínica anterior (GMA) se asoció a los diferentes resultados tempranos y a largo plazo en pacientes con fibrosis a los que se les realizó un TP.Análisis retrospectivo de 92 trasplantes de pulmón unilaterales (TPU) consecutivos para el tratamiento de la fibrosis pulmonar durante un período de 10 años. Se midieron las dimensiones de la GMA en la TC preoperatoria: eje anteroposterior (AP), eje transversal (T) y altura (A). Los volúmenes de GMA (V) se calcularon mediante la fórmula: AP × T × A × 3,14/6.Según las dimensiones radiológicas de la GMA, los pacientes se distribuyeron en 2 grupos: GMA baja (V < 20 cm3) y GMA alta (V > 20 cm3), y los resultados tempranos y a largo plazo se compararon mediante análisis univariables y multivariables.Se realizaron 92 TPU: 73 V/19 M, 53 ± 11 (14-68) años. Mortalidad a 30 días (GMA baja frente a GMA alta): 5 (5,4%) frente a 15 (16,3%); p = 0,014. Los pacientes que desarrollaron disfunción precoz del injerto dentro de las 72 h posteriores al trasplante, y los que murieron dentro de los 30 días posteriores al trasplante presentaron mayores volúmenes de GMA: 21,1 ± 19,8 frente a 43,3 ± 24,7 cm3 (p = 0,03) y 24,4 ± 24,2 frente a 56,9 ± 63,6 cm3 (p < 0,01), respectivamente. Supervivencia global (GMA baja frente a GMA alta) (a los 1, 3 y 5 años): 85, 81 y 78% frente al 55, 40 y 33% (p < 0,001), respectivamente.Los factores que predijeron la mortalidad a los 30 días fueron: IMC (HR = 0,77; p = 0,011), volumen de la GMA (HR = 1,04; p = 0,018), CEC (HR = 1,42; p = 0,002), tiempo de isquemia (HR = 1,01; p = 0,009).Los factores que predijeron la supervivencia fueron: volumen GMA (HR = 1,02; p < 0,001), CEC (HR = 3,17; p = 0,003) y tiempo de isquemia (HR = 1,01; p = 0,001).La evaluación radiológica preoperatoria de las dimensiones y los volúmenes de la grasa mediastínica puede ser una herramienta útil para identificar a aquellos pacientes con fibrosis con mayor riesgo de mortalidad después de un trasplante pulmonar único." @default.
• W4254600513 created "2022-05-12" @default.
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• W4254600513 date "2020-11-01" @default.
• W4254600513 modified "2023-09-25" @default.
• W4254600513 title "Cluster Analysis to Identify Apnea–Hypopnea Syndrome Phenotypes: Where Are We Heading?" @default.
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• W4254600513 doi "https://doi.org/10.1016/j.arbr.2019.11.021" @default.
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