Research Article

Orthostatic Hypotension and Concurrent Autonomic Dysfunction: A Novel Complication of Lung Transplantation

Table 1

Baseline characteristics, pretransplant clinical features, and outcomes in the study cohort.

VariablesStudy cohort, n = 13

Age, years68 (66, 71)
Gender, male12, 92.3
Height, inches70 (68, 72.5)
Body mass index, kg/m2†26.6 (22.8, 28.9)
Lung transplant, bilateral12, 92.3
Underlying diagnosis
 IPF9, 69.2
 COPD3, 23.1
 CPFE1, 7.7
Pre-LTx clinical features
 LAS47.5 (35.4, 54.7)
 Creatinine, mg/dL0.8 (0.8, 1.2)
 Distance walked in six minutes, meters346 (273, 393)
 Right atrial pressure, mmHg7.5 (4, 12.5)
 Mean pulmonary artery pressure, mmHg22 (20, 33)
 Pulmonary capillary wedge pressure, mmHg15 (6, 19)
 Cardiac index3.3 (2.9, 3.7)
 Known orthostatic hypotension1, 7.7
 Arrhythmia4, 30.8
 Preexisting peripheral neuropathy3, 23.1
 Preexisting gastroparesis2, 15.4
Immunosuppression
 Induction: basiliximab10, 76.9
 Induction: rituximab/IVIG2, 15.4
 Induction: ATG1, 7.7
 Mycophenolate mofetil, tacrolimus, steroids13, 100
 Cyclosporin1, 7.7
 Belatacept1, 7.7
Post-LTx clinical features
 Primary graft dysfunction grade 34, 30.8
 Time to endotracheal extubation, days4 (1, 6)
 Atrial fibrillation in first postoperative week9, 69.2
 Decrease in SBP supine to standing56 (38, 66)
 Decrease in DBP supine to standing25 (10.5, 40)
 Supine hypertension10, 76.9
Discharged to home3, 23.1
Inpatient rehabilitation after LTx10, 76.9
Readmissions for inpatient rehabilitations3, 23.1
Number of readmissions in first year2 (1, 3)
Length of stay for readmissions, days18 (13, 29)
Deaths6, 46.2
 1st year3, 23.1
 2nd year2, 15.4
 3rd year1, 7.7

Data expressed as numbers, percentages unless specified otherwise; data expressed as median (interquartile range). IPF, idiopathic pulmonary fibrosis; COPD, chronic obstructive pulmonary disease; CPFE, combined pulmonary fibrosis and emphysema; LTx, lung transplant; LAS, lung allocation score; IVIG, intravenous immunoglobulin; ATG, rabbit antithymocyte globulin; SBP, systolic blood pressure; DBP, diastolic blood pressure.