Venous Thromboembolic Complications of Lung Transplantation: A Contemporary Single-Institution Review

Charles F. Evans, Aldo T. Iacono, Pablo G. Sanchez, Olga Goloubeva, June Kim, Irina Timofte, Faisal H. Cheema, Si M. Pham, Bartley P. Griffith, Keshava Rajagopal

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Abstract

Background The incidence and consequences of deep venous thrombosis (DVT) and pulmonary embolism (PE) have not been described recently in lung transplant recipients. We sought to characterize DVT and PE in a contemporary series of lung transplant recipients and describe their association with clinical outcomes. Methods The records of all lung transplant recipients from July 1, 2008, to June 30, 2013, were reviewed and analyzed. DVT was diagnosed by venous duplex ultrasonography. PE was diagnosed by computed tomography angiography, nuclear ventilation/perfusion scanning, or pulmonary angiography. Results The study comprised 117 patients who underwent 123 transplants. The median age was 63 years (range, 17 to 77 years). Forty-five patients (39%) had evidence of lower extremity DVT, 53 (45%) had no evidence of lower extremity DVT, and 19 (16%) were not tested. Fifty-three (45%) had evidence of upper extremity DVT, 30 (26%) had no evidence of upper extremity DVT, and 34 (29%) were not tested. Eighteen (15%) had evidence of PE, 82 (70%) had no evidence of PE, and 17 (15%) were not tested. A multivariable, stepwise Cox proportional hazards model revealed that the presence of lower extremity DVT (hazard ratio, 2.43; 95% confidence interval, 1.29 to 4.64), use of cardiopulmonary bypass (hazard ratio, 2.21; 95% confidence interval, 1.04 to 4.68), and unilateral lung transplantation (hazard ratio, 2.13; 95% confidence interval, 1.07 to 4.25) were associated with diminished survival. Conclusions The incidence of DVT and PE in lung transplant recipients is high. Posttransplant surveillance and treatment based on findings are warranted.

Original languageEnglish (US)
Pages (from-to)2033-2040
Number of pages8
JournalAnnals of Thoracic Surgery
Volume100
Issue number6
DOIs
StatePublished - Jan 1 2015

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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    Evans, C. F., Iacono, A. T., Sanchez, P. G., Goloubeva, O., Kim, J., Timofte, I., Cheema, F. H., Pham, S. M., Griffith, B. P., & Rajagopal, K. (2015). Venous Thromboembolic Complications of Lung Transplantation: A Contemporary Single-Institution Review. Annals of Thoracic Surgery, 100(6), 2033-2040. https://doi.org/10.1016/j.athoracsur.2015.05.095