Long-term air pollution exposure and the risk of primary graft dysfunction after lung transplantation
Year: 2024
Type: article
Abstract: BACKGROUND: Primary graft dysfunction (PGD) contributes substantially to both short- and long-term mortality after lung transplantation, but the mechanisms that lead to PGD are not well understood. Exposure to ambient air pollutants is associated with adverse events during waitlisting for lung transplantation and chronic lung allograft dysfunction, but its association with PGD has not been studied. We hypothesized that long-term exposure of the lung donor and recipient to high levels of ambient air pollutants would increase the risk of PGD in lung transplant recipients. METHODS: Using data from 1428 lung transplant recipients and their donors enrolled in the Lung Transplant Outcomes Group observational cohort study, we evaluated the association between the development of PGD and zip-code-based estimates of long-term exposure to 6 major air pollutants (ozone, nitrogen dioxide, sulfur dioxide, carbon monoxide, particulate matter 2.5, and particulate matter 10) in both the lung donor and the lung recipient. Exposure estimates used daily EPA air pollutant monitoring data and were based on the geographic centroid of each subject's residential zip code. Associations were tested in both univariable and multivariable models controlling for known PGD risk factors. RESULTS: We did not find strong associations between air pollutant exposures in either the donor or the recipient and PGD. CONCLUSIONS: Exposure to ambient air pollutants, at the levels observed in this study, may not be sufficiently harmful to prime the donor lung or the recipient to develop PGD, particularly when considering the robust associations with other established PGD risk factors.
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,300
Funders: U.S. Department of Defense, U.S. Environmental Protection Agency, California Air Resources Board, Gilead Sciences, University of Pennsylvania, United Therapeutics Corporation, California Institute of Regenerative Medicine, CSL Behring, Arrowhead Pharmaceuticals, CareDx, Akebia Therapeutics, National Institutes of Health, Genentech, Stanford Bio-X, National Heart, Lung, and Blood Institute
Awards: G1897830155, Clinical Risk Factors for Primary Graft Dysfunction, Precision Medicine in the Acute Respiratory Distress Syndrome, Mentored Patient Oriented Research in Lung Transplantation, The GOLD Study: Goal of Open Lung Ventilation in Donors, Long Term Follow up of the Lung Transplant Outcomes Group Cohort, Objective Lung Assessment Tools for Improved Organ Use in Lung Transplantation, Peri-operative factors that drive cell-free hemoglobin-mediated primary graft dysfunction
OpenAlex ID: W4400643784