Abstract | BACKGROUND: METHODS: We included patients transplanted at the University of Pennsylvania from 2005-12, defined AKI using consensus criteria during transplant hospitalization, and defined PGD as grade 3 at 48-72 hours. We used multivariable logistic regression to test the impact of PGD on AKI risk factors and Cox models to test association of AKI with one-year mortality adjusting for PGD and other confounders. RESULTS: Of 299 patients, 188 (62.9%) developed AKI with 142 (75%) cases occurring by postoperative day 4. In multivariable models, PGD was strongly associated with AKI (OR 3.76, 95% CI 1.72-8.19, P = .001) but minimally changed associations of other risk factors with AKI. Both AKI (HR 3.64, 95% CI 1.68-7.88, P = .001) and PGD (HR 2.55, 95% CI 1.40-4.64, P = .002) were independently associated with one-year mortality. CONCLUSIONS: Post-lung transplant AKI risk factors and association of AKI with mortality were independent of PGD. AKI may therefore be a target for improving lung transplant mortality rather than simply an epiphenomenon of PGD.
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Authors | Michael G S Shashaty, Caitlin M Forker, Todd A Miano, Qufei Wu, Wei Yang, Michelle L Oyster, Mary K Porteous, Edward E Cantu 3rd, Joshua M Diamond, Jason D Christie |
Journal | Clinical transplantation
(Clin Transplant)
Vol. 33
Issue 10
Pg. e13678
(10 2019)
ISSN: 1399-0012 [Electronic] Denmark |
PMID | 31355953
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | © 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. |
Topics |
- Acute Kidney Injury
(etiology, mortality, pathology)
- Adult
- Female
- Follow-Up Studies
- Graft Rejection
(etiology, mortality, pathology)
- Graft Survival
- Humans
- Lung Transplantation
(adverse effects, mortality)
- Male
- Middle Aged
- Postoperative Complications
(etiology, mortality, pathology)
- Primary Graft Dysfunction
(etiology, mortality, pathology)
- Prognosis
- Prospective Studies
- Risk Assessment
- Risk Factors
- Survival Rate
- Time Factors
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