Perioperative statin use is associated with decreased incidence of primary graft dysfunction after lung transplantation

Jacob Raphael, Stephen R. Collins, Xin Qun Wang, David C. Scalzo, Priyanka Singla, Christine L. Lau, Benjamin D. Kozower, Marcel E. Durieux, Randal S. Blank

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Background Primary graft dysfunction (PGD) is a major cause of early morbidity and mortality after lung transplantation. Statins reduce the risk of chronic rejection after lung transplantation, but their effects on PGD are unknown. We hypothesized that perioperative statin therapy decreases the risk for PGD after lung transplantation. Methods We retrospectively reviewed records of all patients undergoing lung transplantation between January 1999 and December 2014 at the University of Virginia Health System. The primary outcome was PGD (grades 1-3). Secondary outcomes included grade 3 PGD, length of intensive care unit and hospital stay, and mortality. Results Of 266 patients who met final inclusion criteria, 138 (52%) were diagnosed with PGD. In-hospital mortality among patients with PGD was 6.5%. There were no deaths in patients without PGD (p < 0.001). PGD was diagnosed in 24 patients taking statins (34.8%) and in 114 patients (57.9%) who did not take statins (p = 0.001). After propensity score adjustments, perioperative statin use was independently associated with a reduced risk for PGD (odds ratio [OR] 0.41, 95% confidence interval [CI] 0.20–0.84, p = 0.015) and reduced risk to develop grade 3 PGD (OR 0.42, 95% CI 0.18–0.94, p = 0.036). Other risk factors associated with PGD included intraoperative use of cardiopulmonary bypass (OR 3.74, 95% CI 1.75–8.02, p = 0.001) and positive donor smoking status (OR 2.27, 95% CI 1.18–4.35, p = 0.014). Conclusions The results demonstrate that perioperative use of statins is independently associated with reduced risk for PGD after lung transplantation.

Original languageEnglish
Pages (from-to)948-956
Number of pages9
JournalJournal of Heart and Lung Transplantation
Volume36
Issue number9
DOIs
StatePublished - Sep 2017
Externally publishedYes

Keywords

  • lung transplantation
  • mortality
  • outcomes
  • primary graft dysfunction
  • statins

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