Despite advances in lung transplantation (LTx), morbidity and mortality are high. We hypothesized that pleural effusions requiring thoracocentesis lead to poor outcomes after LTx. We performed a singlecenter retrospective analysis of thoracocenteses after initial hospital discharge in LTx patients between March 2008 and September 2020 to identify risk-factors, etiologies and outcomes. Of the 1,223 patients included, 113 patients (9.2%) required a total of 195 thoracocenteses. The cumulative incidence of thoracocentesis was 10.6% at 1 year and 14.2% at 5 years after transplantation. We observed a bimodal distribution of pleural effusion onset with a threshold at 6 months. Late onset effusions were mostly of malignant or cardiac origin. We observed a high rate of nonspecific effusions (41.5%) irrespective of the timepoint post-transplantation. Patients with late onset effusions had significantly lower survival compared to a matched controlled group (HR 2.43; 95% CI (1.27- 4.62). All pulmonary function parameters were significantly decreased in patients requiring thoracocentesis compared to matched controls. Male sex and re-transplantation were risk factors for pleural effusions. In conclusion, pleural effusions requiring thoracocentesis occur frequently in LTx patients and lead to a reduced long-term allograft function. Late onset effusions are associated with a lower survival.
- Joean, O.
- Kayser, M. Z.
- Valtin, C.
- Ewen, R.
- Gottlieb, J.
Keywords
- allograft function
- lung transplantation
- pleural effusion
- survival
