Female lung transplant recipients at greater risk of acute lung injury

Female lung transplant recipients are significantly more likely to suffer from a type of injury to the transplanted lung called primary graft dysfunction than male lung transplant patients, according to a study to be presented at the American Thoracic Society International Conference on May 24.

The study found that female lung transplant recipients who received a lung from either a male or female donor were almost 60% more likely to suffer from primary graft dysfunction, compared with male recipients who received their lung from a male donor.

“There are a number of possible reasons why women are at increased risk,” said lead researcher Catherine Kuntz, M.D., Pulmonary Fellow at the Hospital of the University of Pennsylvania. “It may involve women’s hormones or differences in their immune systems.”

The study included data on all 7,482 adult lung transplants performed in the United States between 1994 and 2002. The researchers took into account factors such as the donor’s age, race, cause of death, and the recipient’s age, race and reason for lung transplant, as well as the size matching between the donor and recipient.

Overall, approximately 10% of transplant recipients suffered from primary graft dysfunction, which is an acute severe lung injury that occurs within the first 72 hours after the transplant and has a high mortality.

Once the lung is taken out of the donor, it is put on ice, and during this time, no blood flows through the organ. When the lung is transplanted into the recipient and all the blood vessels are reattached, injury to the lung may become apparent. Lung graft dysfunction is associated with a high death rate, prolonged hospital stay and other serious complications.

“We need further investigation into what it is about women that increases the risk,” Dr. Kuntz said. “We need to look at factors such as whether the women have gone through menopause, and how many children they’ve had.”

According to the United Network for Organ Sharing (UNOS) there are currently 3,688 Americans waiting for a lung transplant for diseases including cystic fibrosis, chronic obstructive pulmonary disease (COPD), primary pulmonary hypertension and pulmonary fibrosis.