Plasma intercellular adhesion molecule-1 and von willebrand factor in primary graft dysfunction after lung transplantation
Plasma intercellular adhesion molecule-1 and von willebrand factor in primary graft dysfunction after lung transplantation
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DOI：
10.1111/j.1600-6143.2007.01981.x
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发表时间：
2007-11-01
影响因子：
8.8
通讯作者：
Christie, J. D.
中科院分区：
文献类型：
--
作者：
Covarrubias, M.;Ware, L. B.;Christie, J. D.
原发性移植物功能障碍（PGD）是肺移植后72小时内发生的一种急性肺损伤，其特征是肺水肿和弥漫性肺泡损伤。我们推测，较高浓度的细胞间粘附分子-1（ICAM-1）和血管性血友病因子（vWF）与PGD的发生有关。7个肺移植中心共128例肺移植受者参加了一项多中心、前瞻性、队列研究。分别于术前、术后6、24、48和72 h采集血液标本。主要结局为移植后72小时的3级PGD。采用Logistic回归和广义估计方程（GEE）分析血浆ICAM-1和vWF水平。在每个术后时间点，PGD患者的平均血浆ICAM-1浓度高于无PGD患者。血浆ICAM-1与PGD相关性的GEE对比估计值为107.5 ng/mL（95% CI 38.7，176.3），p = 0.002。在多变量分析中，除了移植前的肺动脉压外，这一发现与所有临床变量无关。血浆vWF水平与PGD无相关性。我们的结论是，较高水平的血浆ICAM-1与PGD肺移植后。
Primary graft dysfunction (PGD), a form of acute lung injury occurring within 72 h following lung transplantation, is characterized by pulmonary edema and diffuse alveolar damage. We hypothesized that higher concentrations of intercellular adhesion molecule-1 (ICAM-1) and von Willebrand factor (vWF) would be associated with the occurrence of PGD. A total of 128 lung transplant recipients among 7 lung transplant centers were enrolled in a multicenter, prospective, cohort study. Blood specimens were collected preoperatively and at 6, 24, 48 and 72 h following lung transplantation. The primary outcome was Grade 3 PGD at 72 h after transplant. Logistic regression and generalized estimating equations (GEE) were used to analyze plasma ICAM-1 and vWF. At each postoperative timepoint, mean plasma ICAM-1 concentrations were higher for patients with PGD versus no PGD. The GEE contrast estimate for the association of plasma ICAM-1 with PGD was 107.5 ng/mL (95% CI 38.7, 176.3), p = 0.002. In the multivariate analyses, this finding was independent of all clinical variables except pulmonary artery pressures prior to transplant. There was no association between plasma vWF levels and PGD. We conclude that higher levels of plasma ICAM-1 are associated with PGD following lung transplantation.