Soluble P-selectin and the risk of primary graft dysfunction after lung transplantation

Steven M. Kawut, Jeffrey Okun, Daichi Shimbo, David J. Lederer, Joao De Andrade, Vibha Lama, Ashish Shah, Aaron Milstone, Lorraine B. Ware, Ann Weinacker, Ejigayehu Demissie, Jason D. Christie

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Platelet activation with subsequent neutrophilic adherence to the vasculature initiates ischemia-reperfusion injury. We hypothesized that higher plasma P-selectin levels reflecting platelet activation would therefore be associated with primary graft dysfunction (PGD) after lung transplantation. Methods: In a prospective, multicenter cohort study of 376 patients who had undergone lung transplantation between 2002 and 2007, we measured soluble P-selectin levels before lung transplantation and at 6 and 24 h after lung reperfusion in 20 patients with grade III PGD (PaO2/fraction of inspired oxygen, <200 mm Hg [with alveolar infiltrates seen on chest radiographs]) at 72 h after transplantation and 61 control subjects without PGD. Results: Higher postoperative soluble P-selectin levels were associated with an increased risk of PGD at 72 h after transplantation (odds ratio [OR] per 1 natural log increase in soluble P-selectin at 6 h after lung allograft reperfusion, 3.5; 95% confidence interval [CI], 1.01 to 11.8; p = 0.048) and at 24 h after lung allograft reperfusion (OR, 4.8; 95% CI, 1.4 to 16.1; p = 0.01). Higher preoperative mean pulmonary artery pressure and the use of cardiopulmonary bypass were also associated with an increased risk of PGD. Conclusion: Higher postoperative soluble P-selectin levels were associated with an increased risk of PGD at 72 h following lung transplantation.

Original languageEnglish (US)
Pages (from-to)237-244
Number of pages8
JournalChest
Volume136
Issue number1
DOIs
StatePublished - Jul 1 2009

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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