Plasma intercellular adhesion molecule-1 and von Willebrand factor in primary graft dysfunction after lung transplantation.

Abstract

Primary graft dysfunction (PGD), a form of acute lung injury occurring within 72 h following lung transplantation, is characterized by pulmonary edema and diffuse alveolar damage. We hypothesized that higher concentrations of intercellular adhesion molecule-1 (ICAM-1) and von Willebrand factor (vWF) would be associated with the occurrence of PGD. A total of 128 lung transplant recipients among 7 lung transplant centers were enrolled in a multicenter, prospective, cohort study. Blood specimens were collected preoperatively and at 6, 24, 48 and 72 h following lung transplantation. The primary outcome was Grade 3 PGD at 72 h after transplant. Logistic regression and generalized estimating equations (GEE) were used to analyze plasma ICAM-1 and vWF. At each postoperative timepoint, mean plasma ICAM-1 concentrations were higher for patients with PGD versus no PGD. The GEE contrast estimate for the association of plasma ICAM-1 with PGD was 107.5 ng/mL (95% CI 38.7, 176.3), p = 0.002. In the multivariate analyses, this finding was independent of all clinical variables except pulmonary artery pressures prior to transplant. There was no association between plasma vWF levels and PGD. We conclude that higher levels of plasma ICAM-1 are associated with PGD following lung transplantation.

• Authors: M Covarrubias, L B Ware, S M Kawut, J De Andrade, A Milstone, A Weinacker, J Orens, V Lama, K Wille, S Bellamy, C Shah, E Demissie, J D Christie, Lung Transplant Outcomes Group
• Journal: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (Am J Transplant) Vol. 7 Issue 11 Pg. 2573-8 (Nov 2007) ISSN: 1600-6135 [Print] United States
• PMID: 17908278 (Publication Type: Journal Article, Multicenter Study, Research Support, N.I.H., Extramural)

Chemical References

• Biomarkers
• von Willebrand Factor
• Intercellular Adhesion Molecule-1

Topics

• Adult
• Biomarkers (blood)
• Cohort Studies
• Female
• Humans
• Intercellular Adhesion Molecule-1 (blood)
• Lung Transplantation (pathology)
• Male
• Middle Aged
• Postoperative Complications (blood)
• Regression Analysis
• Reproducibility of Results
• von Willebrand Factor (metabolism)