Article ; Online: Diaphragmatic plication among lung transplant patients: A single-center experience.
2022 Volume 36, Issue 7, Page(s) e14683
Abstract: Background: There is lack of data reporting outcomes among patients needing diaphragmatic plication (DP) during or after lung transplantation (LT). We sought to assess the association of DP with post-transplant spirometry among other outcomes.: ... ...
Abstract | Background: There is lack of data reporting outcomes among patients needing diaphragmatic plication (DP) during or after lung transplantation (LT). We sought to assess the association of DP with post-transplant spirometry among other outcomes. Methods: We included all patients who underwent LT between 2012 and 2016 (n = 324, mean age 56.3±13.4 years; M:F 198:126). We compared early and late outcomes based on the need for DP. Results: The frequency of diaphragmatic dysfunction (DD) on pre-transplant fluoroscopy was 52.2%. A total of 38 DP procedures were performed among 37 patients (11.4% of LT patients). DP was done for anatomic (sizing or spacing issues) or functional indications (symptomatic DD). While patients with DP had significantly lower spirometry throughout the 3-year follow-up period, their slope of decline, functional assessments at the first annual visit, the risk of CLAD, and mortality were similar to patients without DP. A sub-group analysis limited to patients with restrictive lung diseases as the transplant indication had similar findings. Conclusions: Pre-transplant DD is common among LT candidates although it did not predict the need for DP. DP may be performed for functional or anatomic indications especially for addressing the donor-recipient size mismatch. Despite the lack of favorable effect on post-transplant spirometry, patients undergoing DP have acceptable and comparable early and late outcomes. |
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MeSH term(s) | Adult ; Aged ; Diaphragm ; Humans ; Lung Transplantation ; Middle Aged ; Respiratory Paralysis ; Retrospective Studies |
Language | English |
Publishing date | 2022-05-03 |
Publishing country | Denmark |
Document type | Journal Article |
ZDB-ID | 639001-8 |
ISSN | 1399-0012 ; 0902-0063 |
ISSN (online) | 1399-0012 |
ISSN | 0902-0063 |
DOI | 10.1111/ctr.14683 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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