Retrospective analysis of comorbidities and complications in lung transplantation: Is a new SELeCT score a prognostic tool?

Introduction: Lung transplantation (LTx) is a therapeutical option for end-stage lung diseases. Many factors influence the outcome: pre-LTx status, early or late post-LTx events. Aims: We evaluated the impact of pre- and post-LTx events on survival of patients who underwent to LTx in Turin Lung Transplant Centre. Methods: A retrospective analysis included 54 patients who underwent to LTx between Jan 2010 and Mar 2013 and reached 2 ys follow-up. We evaluated comorbidities, type of surgical procedure and post-LTx trend (functional, infections and rejections). For each post-LTx observation we created a score ( SELeCT ) based on S ympthoms (presence, variability), physical E xamination, Le ucocytosis, leukopenia, increased C RP, new T horacic radiological findings. Results: Coronaric disease and age ≥65 ys were associated with higher mortality. Among LTx, Cystic Fibrosis had higher prevalence of bacterial isolation, fibrotic disease had higher incidence of acute rejections than other groups of patients. In our cohort, survival was inversely correlated to the SELeCT score and number of mycotic isolations. Conclusions: In our experience survival was negatively influenced by age ≥65 ys, hystory of coronaric disease, incidence of mycotic infections and SELeCT score. The new single centre SELeCT score, after more validation studies, could be a useful instrument for guiding diagnostic and therapeutic decision.