Incidence of primary graft dysfunction after lung transplantation is altered by timing of allograft implantation.
retrospective_cohort · Level III
Where this comes from
- Record sourced from PubMed, PMID 30301818.
- Also identified by DOI 10.1136/thoraxjnl-2018-212021 and PMC identifier 6484691.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
The importance of circadian factors in managing patients is poorly understood. We present two retrospective cohort studies showing that lungs reperfused between 4 and 8 AM have a higher incidence (OR 1.12; 95% CI 1.03 to 1.21; p=0.01) of primary graft dysfunction (PGD) in the first 72 hours after transplantation. Cooling of the donor lung, occurring during organ preservation, shifts the donor circadian clock causing desynchrony with the recipient. The clock protein REV-ERBα directly regulates PGD biomarkers explaining this circadian regulation while also allowing them to be manipulated with synthetic REV-ERB ligands.
Medical subject headings
- Circadian Clocks
- Lung Transplantation
- Primary Graft Dysfunction