Connective tissue disease is associated with the risk of posterior reversible encephalopathy syndrome following lung transplantation in Korea

Background Posterior reversible encephalopathy syndrome (PRES) is a rare complication of lung transplantation with poorly understood risk factors and clinical characteristics. This study aimed to examine the occurrence, risk factors, and clinical data of patients who developed PRES following lung tr...

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Main Authors: Tae Jung Kim, Hyun Joo Lee, Samina Park, Sang-Bae Ko, Soo-Hyun Park, Seung Hwan Yoon, Kwon Joong Na, In Kyu Park, Chang Hyun Kang, Young Tae Kim, Sun Mi Choi, Jimyung Park, Joong-Yub Kim, Hong Yeul Lee
Format: Article
Language:English
Published: Korean Society of Critical Care Medicine 2025-02-01
Series:Acute and Critical Care
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Online Access:http://www.accjournal.org/upload/pdf/acc-003384.pdf
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author Tae Jung Kim
Hyun Joo Lee
Samina Park
Sang-Bae Ko
Soo-Hyun Park
Seung Hwan Yoon
Kwon Joong Na
In Kyu Park
Chang Hyun Kang
Young Tae Kim
Sun Mi Choi
Jimyung Park
Joong-Yub Kim
Hong Yeul Lee
author_facet Tae Jung Kim
Hyun Joo Lee
Samina Park
Sang-Bae Ko
Soo-Hyun Park
Seung Hwan Yoon
Kwon Joong Na
In Kyu Park
Chang Hyun Kang
Young Tae Kim
Sun Mi Choi
Jimyung Park
Joong-Yub Kim
Hong Yeul Lee
author_sort Tae Jung Kim
collection DOAJ
description Background Posterior reversible encephalopathy syndrome (PRES) is a rare complication of lung transplantation with poorly understood risk factors and clinical characteristics. This study aimed to examine the occurrence, risk factors, and clinical data of patients who developed PRES following lung transplantation. Methods A retrospective analysis was conducted on 147 patients who underwent lung transplantation between February 2013 and December 2023. The patients were diagnosed with PRES based on the clinical symptoms and radiological findings. We compared the baseline characteristics and clinical information, including primary lung diseases and immunosuppressive therapy related to lung transplantation operations, between the PRES and non-PRES groups. Results PRES manifested in 7.5% (n=11) of the patients who underwent lung transplantation, with a median onset of 15 days after operation. Seizures were identified as the predominant clinical manifestation (81.8%, n=9) in the group diagnosed with PRES. All patients diagnosed with PRES recovered fully. Patients with PRES were significantly associated with connective tissue disease-associated interstitial lung disease (45.5% vs. 18.4%, P=0.019, odds ratio=9.808; 95% CI, 1.064–90.38; P=0.044). Nonetheless, no significant variance was observed in the type of immunotherapy, such as the use of calcineurin inhibitors, blood pressure, or acute renal failure subsequent to lung transplantation. Conclusions PRES typically manifests shortly after lung transplantation, with seizures being the predominant initial symptom. The presence of preexisting connective tissue disease as the primary lung disease represents a significant risk factor for PRES following lung transplantation.
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spelling doaj-art-b8056ea06fdf44ebb2916536096e037a2025-08-20T03:06:02ZengKorean Society of Critical Care MedicineAcute and Critical Care2586-60522586-60602025-02-01401798610.4266/acc.0033841573Connective tissue disease is associated with the risk of posterior reversible encephalopathy syndrome following lung transplantation in KoreaTae Jung Kim0Hyun Joo Lee1Samina Park2Sang-Bae Ko3Soo-Hyun Park4Seung Hwan Yoon5Kwon Joong Na6In Kyu Park7Chang Hyun Kang8Young Tae Kim9Sun Mi Choi10Jimyung Park11Joong-Yub Kim12Hong Yeul Lee13 Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Critical Care Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Neurology, Soonchunhyang University Seoul Hospital, Seoul, Korea Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Pulmonology and Critical Care Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Pulmonology and Critical Care Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Pulmonology and Critical Care Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Critical Care Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, KoreaBackground Posterior reversible encephalopathy syndrome (PRES) is a rare complication of lung transplantation with poorly understood risk factors and clinical characteristics. This study aimed to examine the occurrence, risk factors, and clinical data of patients who developed PRES following lung transplantation. Methods A retrospective analysis was conducted on 147 patients who underwent lung transplantation between February 2013 and December 2023. The patients were diagnosed with PRES based on the clinical symptoms and radiological findings. We compared the baseline characteristics and clinical information, including primary lung diseases and immunosuppressive therapy related to lung transplantation operations, between the PRES and non-PRES groups. Results PRES manifested in 7.5% (n=11) of the patients who underwent lung transplantation, with a median onset of 15 days after operation. Seizures were identified as the predominant clinical manifestation (81.8%, n=9) in the group diagnosed with PRES. All patients diagnosed with PRES recovered fully. Patients with PRES were significantly associated with connective tissue disease-associated interstitial lung disease (45.5% vs. 18.4%, P=0.019, odds ratio=9.808; 95% CI, 1.064–90.38; P=0.044). Nonetheless, no significant variance was observed in the type of immunotherapy, such as the use of calcineurin inhibitors, blood pressure, or acute renal failure subsequent to lung transplantation. Conclusions PRES typically manifests shortly after lung transplantation, with seizures being the predominant initial symptom. The presence of preexisting connective tissue disease as the primary lung disease represents a significant risk factor for PRES following lung transplantation.http://www.accjournal.org/upload/pdf/acc-003384.pdfautoimmune diseaseconnective tissue diseaselung transplantationposterior reversible encephalopathy syndrome
spellingShingle Tae Jung Kim
Hyun Joo Lee
Samina Park
Sang-Bae Ko
Soo-Hyun Park
Seung Hwan Yoon
Kwon Joong Na
In Kyu Park
Chang Hyun Kang
Young Tae Kim
Sun Mi Choi
Jimyung Park
Joong-Yub Kim
Hong Yeul Lee
Connective tissue disease is associated with the risk of posterior reversible encephalopathy syndrome following lung transplantation in Korea
Acute and Critical Care
autoimmune disease
connective tissue disease
lung transplantation
posterior reversible encephalopathy syndrome
title Connective tissue disease is associated with the risk of posterior reversible encephalopathy syndrome following lung transplantation in Korea
title_full Connective tissue disease is associated with the risk of posterior reversible encephalopathy syndrome following lung transplantation in Korea
title_fullStr Connective tissue disease is associated with the risk of posterior reversible encephalopathy syndrome following lung transplantation in Korea
title_full_unstemmed Connective tissue disease is associated with the risk of posterior reversible encephalopathy syndrome following lung transplantation in Korea
title_short Connective tissue disease is associated with the risk of posterior reversible encephalopathy syndrome following lung transplantation in Korea
title_sort connective tissue disease is associated with the risk of posterior reversible encephalopathy syndrome following lung transplantation in korea
topic autoimmune disease
connective tissue disease
lung transplantation
posterior reversible encephalopathy syndrome
url http://www.accjournal.org/upload/pdf/acc-003384.pdf
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