Respiratory medicine · 2026
High-density lipoprotein cholesterol influences the outcomes of lung transplantation in females, but not males.
СтатьяНазвание и аннотация: Перевод в очереди
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Elgharably Haytham, Awad Ahmed K, Lehr Carli J, Budev Marie, McCurry Kenneth R, Smith Jonathan D, Ayyat Kamal S
Аннотация
OBJECTIVE: High-density lipoprotein-cholesterol (HDL-C) has recently garnered attention in lung transplantation studies for its anti-inflammatory properties. Herein, we aimed to study the association between basal HDL-C serum levels and outcomes of lung transplantation with respect to sex.
METHODS: In this retrospective cohort study in a tertiary center between 2009 and 2019, 1063 patients that underwent single or double lung transplant were included. Continuous variables are presented as median [25th - 75th percentiles] and analyzed using the Wilcoxon rank-sum test. Primary outcome was primary graft dysfunction (PGD) at 72 h. Survival was evaluated using Kaplan-Meier analysis. Multivariable logistic regression was used to identify independent risk factors for long term mortality, PGD at 72 h, and chronic lung allograft dysfunction.
RESULTS: Our study had 349 females and 714 males with a median age of 59 [49 - 63] years and 62 [55-67] years, respectively. Recipients with HDL-C >69 mg/dL had significantly better survival (HR 0.73 [95% CI 0.58-0.91, p = 0.03). Dividing the cohort based on sex, high HDL-C in female recipients was associated with significantly better survival, lower PGD grade, and shorter hospital stay. In male recipients, the same trends were observed but did not reach statistical significance. Higher baseline HDL-C level was associated with better survival (HR 0.46, 95% CI 0.22-0.96; p = 0.040), lower risk for PGD (OR 0.611, 95% CI 0.562-0.86, p = 0.002), chronic allograft dysfunction (OR 0.91, 95% CI 0.84-0.98; p=0.012).
CONCLUSION: Higher baseline High-density lipoprotein-cholesterol levels before lung transplant were associated with better outcomes, including lower primary graft dysfunction grades, less graft failure, and better survival. The association between higher high-density lipoprotein-cholesterol levels and better outcomes after lung transplantation in females warrants further studies to better characterize its influence on lung transplantation outcomes.
METHODS: In this retrospective cohort study in a tertiary center between 2009 and 2019, 1063 patients that underwent single or double lung transplant were included. Continuous variables are presented as median [25th - 75th percentiles] and analyzed using the Wilcoxon rank-sum test. Primary outcome was primary graft dysfunction (PGD) at 72 h. Survival was evaluated using Kaplan-Meier analysis. Multivariable logistic regression was used to identify independent risk factors for long term mortality, PGD at 72 h, and chronic lung allograft dysfunction.
RESULTS: Our study had 349 females and 714 males with a median age of 59 [49 - 63] years and 62 [55-67] years, respectively. Recipients with HDL-C >69 mg/dL had significantly better survival (HR 0.73 [95% CI 0.58-0.91, p = 0.03). Dividing the cohort based on sex, high HDL-C in female recipients was associated with significantly better survival, lower PGD grade, and shorter hospital stay. In male recipients, the same trends were observed but did not reach statistical significance. Higher baseline HDL-C level was associated with better survival (HR 0.46, 95% CI 0.22-0.96; p = 0.040), lower risk for PGD (OR 0.611, 95% CI 0.562-0.86, p = 0.002), chronic allograft dysfunction (OR 0.91, 95% CI 0.84-0.98; p=0.012).
CONCLUSION: Higher baseline High-density lipoprotein-cholesterol levels before lung transplant were associated with better outcomes, including lower primary graft dysfunction grades, less graft failure, and better survival. The association between higher high-density lipoprotein-cholesterol levels and better outcomes after lung transplantation in females warrants further studies to better characterize its influence on lung transplantation outcomes.