Incidence, risk factors, and clinical implications of post-operative delirium in lung transplant recipients

Abstract

Post-operative delirium is common in lung transplant recipients, and several potentially modifiable risk factors deserve further study to determine their associated mechanisms and predictive values.

Postoperative Neurocognitive Disorders in Cardiac Surgery: Investigating the Role of Intraoperative Hypotension. A Systematic Review

“…Anderson et al retrospectively analysed data from 155 patients who underwent lung transplantation between June 2013 and July 2016 in order to find the risk factors and determine the long-term impact of delirium [ 31 ]. POD was defined as a presence of the terms “delirium”, “delirious”, “CAM positive” in a patient’s chart or acclaimed treatment with antipsychotics.…”

Cerebral complications of solid organ transplantation

“…Postoperative delirium is a frequent complication of liver, heart and lung transplantation, occurring in 10%-36% of cases [3,[5][6][7], and seems to be less frequent after kidney transplantation [8]. In patients receiving liver transplantation for alcoholic liver disease, increased pre-transplantation serum level of ammonia and shorter duration of abstinence were identified as risk factors [9].…”

“…In patients receiving liver transplantation for alcoholic liver disease, increased pre-transplantation serum level of ammonia and shorter duration of abstinence were identified as risk factors [9]. Data in liver and lung transplant recipients suggest that obesity, pretransplant acute kidney injury, intraoperative complications and benzodiazepine exposure are important risk factors [5][6][7]. Postoperative delirium is associated with adverse outcome, including increased use of hospital resources, graft rejection and mortality.…”

Noteworthy Literature Published in 2018 for Thoracic Organ Transplantation

“…Smith et al 117 also performed a small pilot study demonstrating postoperative cognitive dysfunction to be associated with worse survival, based on neurocognitive assessments performed approximately 6 months after transplantation. 117 Anderson et al 118 performed a retrospective analysis of LTx recipients (n = 155) at their institution to identify the incidence, risk factors, and impact of postoperative delirium. The overall incidence of delirium in the cohort was 36.8% (n = 57), with a median duration of symptoms of 4 days.…”

“…Anderson et al118 Neurological complications are common after LTx and may be associated with higher mortality Abbreviations: DCD, donation after cardiac death; DBD, donation after brain death; PGD, primary graft dysfunction; TBI, traumatic brain injury; IVDU, intravenous drug use; EVLP, ex vivo lung perfusion; MCS, mechanical circulatory support; CPB, cardiopulmonary bypass; ECMO, extracorporeal membrane oxygenation; CF, cystic fibrosis; LAS, lung allocation score; LTx, lung transplantation.…”