Single-Lung Transplantation in the Setting of Aborted Bilateral Lung Transplantation

Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
Journal of Transplantation 06/2011; 2011(2090-0007):535649. DOI: 10.1155/2011/535649
Source: PubMed

ABSTRACT Background. The outcome of patients undergoing a single-lung transplant in the setting of an aborted bilateral lung transplant is unclear. Methods. A retrospective review of single lung transplants at an institutional program. Results. Of the 543 lung transplants performed over the last 10 years, 31 (5.7%) were single-lung transplants. Nineteen of 31 (61%) were planned single-lung transplants, while 12/31 (39%)
were intraoperatively aborted, double lung transplants converted to single-lung transplants. The aborted and planned groups were
similar in age, lung allocation score and NYHA status. The reasons for aborted double lung transplantation were cardiac/hemodynamic instability 4/12 (33%), difficult pneumonectomy 3/12 (25%), size mismatch 4/12(33%), and technical issues 1/12 (8%). The aborted group had higher CPB utilization (5/12 versus 1/19, P = .02), similar ischemic times (260 versus 234 min) and similar incidence of grade 3 primary graft dysfunction (6/12 versus 3/19, P = .13). ECMO was required for graft dysfunction in 2 patients in the aborted group. The one and two-year survival was 84% and 79% in the planned group and 62% and 52% in the aborted group, respectively. Conclusions. Patients undergoing single-lung transplantation in the setting of an aborted bilateral lung transplant may be at a higher risk of
worse outcomes.

Download full-text


Available from: Masina Scavuzzo, Jul 30, 2015
1 Follower
  • [Show abstract] [Hide abstract]
    ABSTRACT: JID: 9102703; 0 (Immunosuppressive Agents); 2009/06/23 [received]; 2009/08/04 [revised]; 2009/08/05 [accepted]; ppublish
    The Journal of heart and lung transplantation: the official publication of the International Society for Heart Transplantation 10/2009; 28(10):1007-22. DOI:10.1016/j.healun.2009.08.014 · 5.61 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The technical details of lung transplantation have seen considerable refinement with two decades of experience. Recent efforts to expand the donor pool are an exciting development. The technical details of donor organ procurement and the implantation are discussed here with a note to common pitfalls encountered.
    Seminars in Thoracic and Cardiovascular Surgery 02/2008; 20(2):152-64. DOI:10.1053/j.semtcvs.2008.05.001
  • [Show abstract] [Hide abstract]
    ABSTRACT: To compare long-term health-related quality of life (HRQL) in single and bilateral lung transplant recipients independent of the underlying disease, and in a subset of patients with native pulmonary emphysema. Forty-four lung transplant recipients (mean [+/- SD] age, 44.8 +/- 11.6 years) were followed up for > 2 years after single lung transplantation (LTx) [14 recipients] or bilateral LTx (30 recipients). Data were prospectively collected, before undergoing LTx and annually after undergoing LTx, measuring FEV1, 6-min walk test (6MWT) results, and quality of life using the St. George respiratory questionnaire (SGRQ) and a visual analog scale (VAS). The SGRQ addresses three domains, namely, respiratory symptoms, accomplishment of routine activities, and disease impact on daily life. Statistically significant correlation coefficients were found comparing the SGRQ and the VAS (r = 0.812; p < 0.0001), the SGRQ and the 6MWT (r = 0.610; p < 0.0001), and the SGRQ and the FEV1 (r = 0.523; p < 0.0001) in all patients. Significant improvements on the FEV1, 6MWT, and SGRQ were observed after LTx in both single and bilateral LTx recipients. Increased risk for the development of bronchiolitis obliterans syndrome (BOS) [relative risk, 2.86; 95% confidence interval, 1.22 to 6.67; p = 0.03] and significantly lower FEV1 values were observed in patients following a single graft, compared to that in patients following a bilateral graft (p < 0.01). In contrast, the 6MWT and the SGRQ scores were not significantly different between recipients of single and double LTx. The same patterns of results were observed in comparisons between single and bilateral lung recipients with prior pulmonary emphysema. Despite poorer FEV1 recovery and increased risk of BOS after LTx, single lung transplant recipients had comparable long-term exercise tolerance and quality-of-life scores as patients who received bilateral transplants. These results suggest the limited influence of functional performance on objective and subjective markers of HRQL recovery after LTx.
    Chest 10/2005; 128(3):1371-8. DOI:10.1378/chest.128.3.1371 · 7.13 Impact Factor
Show more