Science and Research

Risk factors and outcomes of vocal cord paralysis after lung transplantation - a retrospective cohort study

Vocal cord paralysis (VCP) may complicate thoracic surgery and is associated with increased morbidity and mortality. Among lung transplant (LTx) recipients, chronic pulmonary aspiration can contribute to chronic allograft dysfunction (CLAD). We herein assessed the unknown incidence and clinical impact of VCP in a large LTx cohort. All first-time bilateral LTx recipients, transplanted between January 2010 and June 2015 were included in a single-centre retrospective analysis. Bronchoscopy reports were assessed for VCP. Patients exhibiting VCP were compared to propensity score-matched negative controls regarding CLAD onset and graft survival and secondary end-points, including inpatient duration and complications; lower respiratory tract infections (LRTI) within 24 months. In total, 583/713 (82%) patients were included in the analysis. A total of 52 (8.9%) exhibited VCP, which was transient in 34/52 patients (65%), recovering after median 6 months (IQR 2-12). Compared to 268 controls, 3-year graft survival and CLAD-free survival were non-inferior in VCP [HR 0.74 (95% CI 0.35-1.57), and HR 0.74 (95% CI 0.39-1.41)] respectively. Duration of hospitalization was similar and no differences in LRTI rates or airway complications were observed. Lower pre-Tx BMI increased risk for VCP [HR 0.88 (95% CI 0.79-0.99)]. Overall, VCP did not adversely affect graft and CLAD-free survival and secondary outcomes including LRTIs and hospitalizations.

  • Seeliger, B.
  • Drick, N.
  • Avsar, M.
  • Tudorache, I.
  • Welte, T.
  • Gottlieb, J.
  • Greer, M.

Keywords

  • Adult
  • Bronchoscopy
  • Female
  • Graft Survival
  • Hospitalization
  • Humans
  • Incidence
  • Length of Stay
  • Lung Diseases/*surgery
  • Lung Transplantation/*adverse effects
  • Male
  • Middle Aged
  • Postoperative Complications
  • Primary Graft Dysfunction/etiology
  • Propensity Score
  • Respiratory Tract Infections/complications
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Vocal Cord Paralysis/*etiology
  • lung transplantation
  • vocal cord paralysis
Publication details
DOI: 10.1111/tri.13402
Journal: Transplant international : official journal of the European Society for Organ Transplantation
Pages: 626-634 
Number: 6
Work Type: Original
Location: BREATH
Disease Area: ROR
Partner / Member: MHH
Access-Number: 30663812
See publication on PubMed

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