{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T17:28:52Z","timestamp":1762363732993,"version":"build-2065373602"},"reference-count":13,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Primary graft dysfunction (PGD) is the leading cause of early mortality after lung transplantation. Albumin is commonly used during lung transplantation to maintain intravascular volume while minimizing total intravenous fluid administration, given the established association between larger intravenous fluid and PGD. However, the direct impact of albumin on PGD remains unclear. Methods: We conducted a single-center retrospective cohort study of lung transplant recipients between 2018 and 2023. We calculated the corrected albumin proportion (cAP), representing the ratio of albumin to total intravenous fluid administered. We analyzed associations between cAP and PGD at 24, 48, and 72 h, as well as secondary outcomes including total fluid administration, 30-day acute kidney injury, mortality, and ICU length of stay. Results: A total of 190 patients were included in this study. A higher cAP was associated with lower total intravenous fluid administration (r = \u22120.15, p = 0.03), whereas a higher total intravenous fluid administration was associated with higher PGD at 72 h (OR 1.02, 95% CI 1.00\u20131.03, p = 0.04). However, cAP was not independently associated with PGD or other short-term outcomes. Conclusions: Intraoperative albumin use modestly reduced total intravenous fluid administration but was not independently associated with significant reductions in PGD or improvements in other short-term outcomes.<\/jats:p>","DOI":"10.3390\/jcm14217843","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T17:06:06Z","timestamp":1762362366000},"page":"7843","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Intraoperative Albumin Use During Lung Transplantation on Primary Graft Dysfunction"],"prefix":"10.3390","volume":"14","author":[{"given":"Yoshio","family":"Tatsuoka","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Perioperative Care, and Pain Medicine, New York University Langone Health, New York, NY 10016, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7280-3182","authenticated-orcid":false,"given":"Krzysztof J.","family":"Zembrzuski","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative Care, and Pain Medicine, New York University Langone Health, New York, NY 10016, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jake G.","family":"Natalini","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, New York University Langone Health, New York, NY 10016, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie H.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, New York University Langone Health, New York, NY 10016, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennie Y.","family":"Ngai","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative Care, and Pain Medicine, New York University Langone Health, New York, NY 10016, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1016\/j.healun.2021.07.012","article-title":"International consensus recommendations for anesthetic and intensive care management of lung transplantation. An EACTAIC, SCA, ISHLT, ESOT, ESTS, and AST approved document","volume":"40","author":"Marczin","year":"2021","journal-title":"J. Heart Lung Transplant."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1164\/rccm.200409-1243OC","article-title":"The effect of primary graft dysfunction on survival after lung transplantation","volume":"171","author":"Christie","year":"2005","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1016\/j.healun.2017.07.021","article-title":"Report of the ISHLT Working Group on Primary Lung Graft Dysfunction, part I: Definition and grading-A 2016 Consensus Group statement of the International Society for Heart and Lung Transplantation","volume":"36","author":"Snell","year":"2017","journal-title":"J. Heart Lung Transplant."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1822","DOI":"10.1056\/NEJMra2401039","article-title":"Lung Transplantation","volume":"391","author":"Christie","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1093\/bja\/aep008","article-title":"Does anaesthetic management affect early outcomes after lung transplant? An exploratory analysis","volume":"102","author":"McIlroy","year":"2009","journal-title":"Br. J. Anaesth."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"78","DOI":"10.5606\/tgkdc.dergisi.2023.22917","article-title":"Effects of intraoperative fluid therapy on intensive care process, morbidity, and mortality after lung transplantation","volume":"31","author":"Bindal","year":"2023","journal-title":"Turk. Gogus Kalp Damar Cerrahisi Derg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1213\/ANE.0000000000001163","article-title":"Increased Intraoperative Fluid Administration Is Associated with Severe Primary Graft Dysfunction After Lung Transplantation","volume":"122","author":"Geube","year":"2016","journal-title":"Anesth. Analg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1080\/03007995.2020.1840970","article-title":"Phases of fluid management and the roles of human albumin solution in perioperative and critically ill patients","volume":"36","author":"Wiedermann","year":"2020","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2722","DOI":"10.1053\/j.jvca.2024.06.041","article-title":"Perioperative Albumin Among Adults Undergoing Thoracic Surgery in the United States: Utilization, Associations With Clinical Outcomes, and Contribution to Hospital Costs","volume":"38","author":"Ellis","year":"2024","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.bja.2023.11.009","article-title":"Intravenous albumin in cardiac and vascular surgery: A systematic review and meta-analysis","volume":"132","author":"Skubas","year":"2024","journal-title":"Br. J. Anaesth."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1053\/j.jvca.2019.08.037","article-title":"The Impact of Anesthetic Management on Perioperative Outcomes in Lung Transplantation","volume":"34","author":"Martin","year":"2020","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Liu, Y., Liu, Y., Su, L., and Jiang, S.J. (2014). Recipient-related clinical risk factors for primary graft dysfunction after lung transplantation: A systematic review and meta-analysis. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0092773"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1001\/jama.2022.10461","article-title":"Effect of 4% Albumin Solution vs Ringer Acetate on Major Adverse Events in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass: A Randomized Clinical Trial","volume":"328","author":"Pesonen","year":"2022","journal-title":"JAMA"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/21\/7843\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T17:25:28Z","timestamp":1762363528000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/21\/7843"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,5]]},"references-count":13,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["jcm14217843"],"URL":"https:\/\/doi.org\/10.3390\/jcm14217843","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,5]]}}}