Impact of Prolonged Cold Ischemia Time on Long-Term Survival in Lung Transplant Recipients

Marek Ochman; Fryderyk Zawadzki; Dagmara Galle; Tomasz Hrapkowicz

doi:10.1016/j.transproceed.2024.04.003

Impact of Prolonged Cold Ischemia Time on Long-Term Survival in Lung Transplant Recipients

Transplant Proc. 2024 May 9:S0041-1345(24)00240-9. doi: 10.1016/j.transproceed.2024.04.003. Online ahead of print.

Authors

Marek Ochman¹, Fryderyk Zawadzki², Dagmara Galle³, Tomasz Hrapkowicz³

Affiliations

¹ Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland. Electronic address: ochmann@wp.pl.
² Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland; Department of Lung Diseases and Tuberculosis, Medical University of Silesia in Katowice, Stanisław Szyszko Independent Public Clinical Hospital No. 1, Zabrze, Poland.
³ Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland.

PMID: 38729831
DOI: 10.1016/j.transproceed.2024.04.003

Abstract

Background: Cold ischemia time (CIT) influences short- and long-term outcomes in lung transplant recipients. Most studies proved that prolonged CIT causes increased mortality. This study aimed to investigate the impact of prolonged CIT on patient survival time after lung transplantation (LTx).

Methods: The retrospective study group consisted of 139 patients who underwent double LTx in a single center between January 2018 and August 2022. Prolonged ischemic time (PIT) was defined as total ischemic time >6 hours and divided into smaller time intervals according to increasing PIT (6-8, 8-10, 10-12, >12 hours). The assessed outcomes were 1- and 4-year survival.

Results: Among the study group, PIT was observed in 98% (n = 137), and its average value was 10.33 hours. The prolonged CIT of 6 to 8 hours occurred in 10% (n = 14), 8 to 10 hours in 34% (n = 47), 10 to 12 hours in 36% (n = 49), and >12 hours in 20% (n = 27). In a comparison of 1-year survival between the PIT 6- to 10-hour group and the >10-hour arm (88% vs 78%), the difference was not statistically significant (P > .05).

Conclusion: PIT is a risk factor for reduced long-term survival in LTx recipients. Increasing PIT may be associated with higher mortality at 1 and 4 years. All efforts to reduce the duration of ischemic time can benefit patient survival after LTx.