Preoperative risk factors of airway complications in adult lung transplant recipients: A systematic review and meta-analysis.

BACKGROUND

In this systematic review and meta-analysis, we aimed to identify recipient-related preoperative risk factors for airway complications following lung transplantation in adults.

METHODS

Articles published between November 1995 and February 2023 were searched by a thorough exploration of databases. Studies that addressed recipient-related risk factors for airway complications following adult lung transplantation, such as cohorts, case-control, or cross-sectional studies, were included. Fixed-effects or random-effects models were used to calculate the odds ratios (ORs) or mean differences (MDs) with 95% confidence interval (CI).

RESULTS

Twenty-one studies including a total of 38,321 recipients fulfilled the inclusion criteria. Based on the pooled analyses, taller height (MD=5.98, 95% CI: 5.69-6.27, =57.32%), intraoperative mechanical ventilation (OR=1.83, 95% CI: 1.41-2.38, =0%), male sex (OR=1.52, 95% CI: 1.33-1.74, =15.91%), preoperative extracorporeal membrane oxygenation (OR=1.58, 95% CI: 1.1-2.26, =41.47%), and preoperative steroid use (OR=1.21, 95% CI: 1.04-1.41, =0%) elevated the risk of airway complications following lung transplantation.

CONCLUSION

Taller height, intraoperative mechanical ventilation, male sex, preoperative extracorporeal membrane oxygenation, and preoperative steroid use can increase the risk of airway complications after lung transplantation. Identifying high-risk recipients or riskless situations can support the advancement of selective treatments or prevent the unnecessary avoidance of certain interventions.