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Preoperative corticosteroids. A contraindication to lung transplantation?
H J Schäfers1, T O Wagner, S Demertzis
1Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Germany.
Chest
|November 1, 1992
Summary
Preoperative corticosteroid use does not increase risks in lung transplantation. Patients continuing prednisolone medication up to 0.3 mg/kg/day showed similar outcomes to those who stopped steroids before surgery.
Area of Science:
- Cardiology
- Pulmonology
- Transplantation Medicine
Background:
- Corticosteroids have been a contraindication for lung transplantation due to perceived risks.
- Recent advancements allow transplantation in patients unable to discontinue steroid therapy preoperatively.
Purpose of the Study:
- To evaluate the impact of regular preoperative corticosteroid administration on lung transplantation outcomes.
- To determine if patients requiring continued steroid medication should be excluded from lung transplantation.
Main Methods:
- Analysis of 27 lung transplantations in 26 patients (up to February 1991).
- Group 1: Corticosteroid therapy discontinued ≥3 months prior (13 patients).
- Group 2: Continued daily corticosteroid (prednisolone, 0.1-0.3 mg/kg/day) therapy (14 patients).
Main Results:
- No significant differences in sex, age, diagnosis, or transplant type between groups.
- Similar rates of postoperative bronchial complications (dehiscence, stenosis) and mortality (one death per group).
Conclusions:
- Regular preoperative administration of prednisolone up to 0.3 mg/kg/day does not increase morbidity or mortality in lung transplantation.
- Patients unable to discontinue steroid medication should not be excluded if otherwise suitable candidates.