Lung Retransplantation Due to Chronic Lung Allograph Dysfunction: Results From a Spanish Transplant Unit.

Autor: Revilla-López E; Servicio de Neumologia, Hospital Vall d'Hebron Barcelona, Universitat Autònoma de Barcelona, Barcelona, España., Berastegui C; Servicio de Neumologia, Hospital Vall d'Hebron Barcelona, Universitat Autònoma de Barcelona, Barcelona, España. Electronic address: cberaste@vhebron.net., Sáez-Giménez B; Servicio de Neumologia, Hospital Vall d'Hebron Barcelona, Universitat Autònoma de Barcelona, Barcelona, España., Lopez-Meseguer M; Servicio de Neumologia, Hospital Vall d'Hebron Barcelona, Universitat Autònoma de Barcelona, Barcelona, España., Monforte V; Servicio de Neumologia, Hospital Vall d'Hebron Barcelona, Universitat Autònoma de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, España., Bravo C; Servicio de Neumologia, Hospital Vall d'Hebron Barcelona, Universitat Autònoma de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, España., Sacanell Lacasa J; Servicio de Cuidados Intensivos, Hospital Vall d'Hebron Barcelona, Universitat Autònoma de Barcelona, Barcelona, España., Romero Vielva L; Servicio de Cirugia Torácica, Hospital Vall d'Hebron Barcelona, Universitat Autònoma de Barcelona, Barcelona, España., Moreno Galdo A; Servicio de Pediatria, Hospital Vall d'Hebron Barcelona, Universitat Autònoma de Barcelona, Barcelona, España., Roman A; Servicio de Neumologia, Hospital Vall d'Hebron Barcelona, Universitat Autònoma de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, España.
Jazyk: English; Spanish; Castilian
Zdroj: Archivos de bronconeumologia [Arch Bronconeumol (Engl Ed)] 2019 Mar; Vol. 55 (3), pp. 134-138. Date of Electronic Publication: 2018 Aug 18.
DOI: 10.1016/j.arbres.2018.07.025
Abstrakt: Introduction: Long-term survival of lung transplantation (LT) patients is mainly limited by the development of chronic lung allograft dysfunction (CLAD). Lung retransplantation (LR) is an alternative for a selected population. The aim of this study was to review the LR experience in our center.
Patients and Methods: We conducted a retrospective study of patients undergoing LR between August 1990 and July 2017.
Results: Fourteen LR out of a total of 998 (1.4%) LT were performed. Twelve patients (85.7%) underwent LR due to CLAD: 10 (71.4%) because of bronchiolitis obliterans syndrome and 2 (14.3%) due to restrictive allograft syndrome. LR was performed in 2 patients within 30 days of the first LT. In those who underwent LR due to CLAD, mean time between the first LT and LR was 48 months, and mean duration of invasive mechanical ventilation was 32 days. The increase in FEV 1 after LR was 24±18%. The best spirometry values were observed after 7.3 months. Mean survival of the cohort was 43.8 months. In patients with bronchiolitis obliterans syndrome, mean survival was 63.4 months, while in those with restrictive allograft syndrome, it was 19.5 months. Only 1 of the 2 early LR patients survived.
Conclusion: LR is a therapeutic option in selected patients with CLAD, with acceptable survival. Indication for LR early after LT shows poor outcomes.
(Copyright © 2018 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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