Obesity and primary graft dysfunction after lung transplantation: The lung transplant outcomes group obesity study

David J. Lederer*, Steven M. Kawut, Nancy Wickersham, Christopher Winterbottom, Sangeeta Bhorade, Scott M. Palmer, James Lee, Joshua M. Diamond, Keith M. Wille, Ann Weinacker, Vibha N. Lama, Maria Crespo, Jonathan B. Orens, Joshua R. Sonett, Selim M. Arcasoy, Lorraine B. Ware, Jason D. Christie

*Corresponding author for this work

Research output: Contribution to journalArticle

81 Scopus citations

Abstract

Rationale: Obesity has been linked to acute lung injury and is a risk factor for early mortality after lung transplantation. Objectives: To examine the associations of obesity and plasma adipokines with the risk of primary graft dysfunction after lung transplantation. Methods: 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. Measurements and Main Results: 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. Conclusions: Obesity is an independent risk factor for primary graft dysfunction after lung transplantation.

Original languageEnglish (US)
Pages (from-to)1055-1061
Number of pages7
JournalAmerican journal of respiratory and critical care medicine
Volume184
Issue number9
DOIs
StatePublished - Nov 1 2011

Keywords

  • Acute lung injury
  • Leptin
  • Lung transplantation
  • Obesity
  • Primary graft dysfunction

ASJC Scopus subject areas

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

Fingerprint Dive into the research topics of 'Obesity and primary graft dysfunction after lung transplantation: The lung transplant outcomes group obesity study'. Together they form a unique fingerprint.

  • Cite this

    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). Obesity and primary graft dysfunction after lung transplantation: The lung transplant outcomes group obesity study. American journal of respiratory and critical care medicine, 184(9), 1055-1061. https://doi.org/10.1164/rccm.201104-0728OC