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Obesity and Primary Graft Dysfunction after Lung Transplantation The Lung Transplant Outcomes Group Obesity Study AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE Lederer, D. J., Kawut, S. M., Wickersham, N., Winterbottom, C., Bhorade, S., Palmer, S. M., Lee, J., Diamond, J. M., Wille, K. M., Weinacker, A., Lama, V. N., Crespo, M., Orens, J. B., Sonett, J. R., Arcasoy, S. M., Ware, L. B., Christie, J. D. 2011; 184 (9): 1055-1061

Abstract

Obesity has been linked to acute lung injury and is a risk factor for early mortality after lung transplantation.To examine the associations of obesity and plasma adipokines with the risk of primary graft dysfunction after lung transplantation.We performed a prospective cohort study of 512 adult lung transplant recipients with chronic obstructive pulmonary disease or interstitial lung disease enrolled in the Lung Transplant Outcomes Group Study. In a nested case-control study, we measured plasma leptin, adiponectin, and resistin before lung transplantation and 6 and 24 hours after lung transplantation in 40 cases of primary graft dysfunction and 80 control subjects. Generalized linear mixed models and logistic regression were used to estimate risk ratios and odds ratios.Grade 3 primary graft dysfunction developed within 72 hours of transplantation in 29% participants. Obesity was associated with a twofold increased risk of primary graft dysfunction (adjusted risk ratio 2.1; 95% confidence interval, 1.7-2.6). The risk of primary graft dysfunction increased by 40% (confidence interval, 30–50%) for each 5 kg/m(2) increase in body mass index after accounting for center, diagnosis, cardiopulmonary bypass, and transplant procedure. Higher plasma leptin levels were associated with a greater risk of primary graft dysfunction (sex-adjusted P = 0.02). The associations of both obesity and leptin with primary graft dysfunction tended to be stronger among those who did not undergo cardiopulmonary bypass.Obesity is an independent risk factor for primary graft dysfunction after lung transplantation.

View details for DOI 10.1164/rccm.201104-0728OC

View details for Web of Science ID 000296613900015

View details for PubMedID 21799077

View details for PubMedCentralID PMC3208644