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Risk Factors for Venous Thromboembolism After Lung Transplantation^*

Hilary A. Yegen, MD; David J. Lederer, MD; R. Graham Barr, MD, DrPh; Jessie S. Wilt, MD; Yixin Fang, PhD; Emilia Bagiella, PhD; Frank D’Ovidio, MD; Jeffrey M. Okun, BA; Joshua R. Sonett, MD; Selim M. Arcasoy, MD, FCCP and Steven M. Kawut, MD, MS, FCCP

^* From the Departments of Medicine (Drs. Yegen, Lederer, Barr, Wilt, Arcasoy, and Kawut, and Mr. Okun) and Surgery (Drs. D’Ovidio and Sonett), College of Physicians and Surgeons, the Department of Statistics (Dr. Fang), Graduate School of Arts and Sciences, and the Department of Biostatistics (Dr. Bagiella), Mailman School of Public Health, Columbia University, New York, NY.

Correspondence to: Steven M. Kawut, MD, MS, FCCP, Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, 622 W 168th St, PH 8, Room 101, New York, NY 10032; e-mail: sk2097{at}columbia.edu

Abstract

Background: The risk factors for venous thromboembolism (VTE) following lung transplantation are not well established. We aimed to estimate the incidence of VTE and to identify the risk factors for VTE after lung transplantation.

Methods: We performed a nested case-control study within the cohort of 121 patients who underwent lung transplantation at our center between August 2001 and July 2005. Control subjects were matched to case patients on the number of days from the time of transplant. Cox proportional hazards models were used to identify risk factors for VTE.

Results: Twenty-four patients had deep vein thromboses, and 6 patients had pulmonary emboli (3 patients had both) [22% of the cohort]. In multivariate models, older age (p < 0.05), diabetes mellitus (p = 0.03), and pneumonia (p = 0.02) were associated with a higher rate of VTE.

Conclusions: VTE is a frequent complication of lung transplantation. Older age, diabetes, and pneumonia increase the rate of VTE. Future studies of intensive VTE prophylaxis may be warranted.

Key Words: lung transplantation • pulmonary embolism • venous thrombosis