{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T16:57:52Z","timestamp":1788368272846,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T00:00:00Z","timestamp":1694390400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The postoperative hemodynamic management after lung transplant (LUTX) is guided by limited evidence. We aimed to describe and evaluate risk factors and outcomes of postoperative vasoactive support of LUTX recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a single\u2010center retrospective analysis of consecutive adult LUTX, two cohorts were identified: (1) patients needing prolonged vasoactive support (&gt;12\u00a0h from ICU admission) (VASO+); (2) or not (VASO\u2212). Postoperative hemodynamic characteristics were thoroughly analyzed. Risk factors and outcomes of VASO+ versus VASO\u2212 cohorts were assessed by multivariate logistic regression and propensity score matching.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred and thirty\u2010eight patients were included (86 (62%) VASO+ versus 52 (38%) VASO\u2212). Vasopressors (epinephrine, norepinephrine, dopamine) were used in the first postoperative days (vasoactive inotropic score at 12\u00a0h: 6 [4\u201312]), while inodilators (dobutamine, levosimendan) later. Length of vasoactive support was 3 [2\u20134] days. Independent predictors of vasoactive use were: LUTX indication different from cystic fibrosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.003), higher Oto score (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.020), longer cold ischemia time (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.031), but not preoperative cardiac catheterization. VASO+ patients showed concomitant hemodynamic and graft impairment, with longer mechanical ventilation (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.010), higher primary graft dysfunction (PGD) grade at 72\u00a0h (PGD grade\u00a0&gt;\u00a00 65% vs. 31%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.004, OR 4.2 [1.54\u201311.2]), longer ICU (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.001) and hospital stay (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.013). Levosimendan as a second\u2010line inodilator appeared safe.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Vasoactive support is frequently necessary after LUTX, especially in recipients of grafts of lesser quality. Postoperative hemodynamic dysfunction requiring vasopressor support and graft dysfunction may represent a clinical continuum with immediate and long\u2010term consequences. Further studies may elucidate if this represents a possible treatable condition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.15122","type":"journal-article","created":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T05:24:19Z","timestamp":1694409859000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Hemodynamic failure and graft dysfunction after lung transplant: A possible clinical continuum with immediate and long\u2010term consequences"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0877-7626","authenticated-orcid":false,"given":"Vittorio","family":"Scaravilli","sequence":"first","affiliation":[{"name":"Department of Anesthesia, Critical Care and Emergency Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan(MI) Italy"},{"name":"Department of Biomedical, Surgical and Dental Sciences University of Milan  Milan(MI) Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amedeo","family":"Guzzardella","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan(MI) Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana","family":"Madotto","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan(MI) Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letizia Corinna","family":"Morlacchi","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan(MI) Italy"},{"name":"Department of Internal Medicine Respiratory Unit and Cystic Fibrosis Center Fondazione IRCCS Ca' Granda \u2013 Ospedale Maggiore Policlinico  Milan(MI) Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Bosone","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan(MI) Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Bonetti","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan(MI) Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Musso","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan(MI) Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Rossetti","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan(MI) Italy"},{"name":"Department of Internal Medicine Respiratory Unit and Cystic Fibrosis Center Fondazione IRCCS Ca' Granda \u2013 Ospedale Maggiore Policlinico  Milan(MI) Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo Maria","family":"Russo","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Emergency Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan(MI) Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo Del","family":"Sorbo","sequence":"additional","affiliation":[{"name":"Interdepartmental Division of Critical Care Medicine Toronto General Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Blasi","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan(MI) Italy"},{"name":"Department of Internal Medicine Respiratory Unit and Cystic Fibrosis Center Fondazione IRCCS Ca' Granda \u2013 Ospedale Maggiore Policlinico  Milan(MI) Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Nosotti","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan(MI) Italy"},{"name":"Department of Cardio\u2010thoraco\u2010vascular diseases Fondazione IRCCS Ca' Granda \u2013 Ospedale Maggiore Policlinico  Milan(MI) Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Zanella","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Emergency Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan(MI) Italy"},{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan(MI) Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Grasselli","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Critical Care and Emergency Fondazione IRCCS Ca' Granda Ospedale Maggiore 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