Single vs Bilateral Lung Transplant in the Management of Patients With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis.

Autor: Mansour R; St George's University of London, London SW17 0RE, UK; University of Nicosia Medical School, University of Nicosia, 2417, Nicosia, Cyprus., Nakanishi H; St George's University of London, London SW17 0RE, UK; University of Nicosia Medical School, University of Nicosia, 2417, Nicosia, Cyprus., Al Sabbakh N; St George's University of London, London SW17 0RE, UK; University of Nicosia Medical School, University of Nicosia, 2417, Nicosia, Cyprus., El Ghazal N; St George's University of London, London SW17 0RE, UK; University of Nicosia Medical School, University of Nicosia, 2417, Nicosia, Cyprus., Haddad J; St George's University of London, London SW17 0RE, UK; University of Nicosia Medical School, University of Nicosia, 2417, Nicosia, Cyprus., Adra M; St George's University of London, London SW17 0RE, UK; University of Nicosia Medical School, University of Nicosia, 2417, Nicosia, Cyprus., Matar RH; St George's University of London, London SW17 0RE, UK; University of Nicosia Medical School, University of Nicosia, 2417, Nicosia, Cyprus; Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN., Tosovic D; School of Biomedical Sciences, The University of Queensland, St Lucia, 4072, Australia., Than CA; St George's University of London, London SW17 0RE, UK; University of Nicosia Medical School, University of Nicosia, 2417, Nicosia, Cyprus; School of Biomedical Sciences, The University of Queensland, St Lucia, 4072, Australia., Song TH; Department of Surgery, University of Chicago Medical Center, Chicago, IL. Electronic address: thsong@uchicago.edu.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2023 Nov; Vol. 55 (9), pp. 2203-2211. Date of Electronic Publication: 2023 Oct 04.
DOI: 10.1016/j.transproceed.2023.08.013
Abstrakt: Background: Lung transplantation is recommended for select patients with end-stage chronic obstructive pulmonary disease (COPD). However, a consensus has not been reached regarding the optimal choice of lung transplantation: single lung transplants (SLTs) vs bilateral lung transplants (BLTs). This meta-analysis aimed to evaluate the safety and efficacy of SLT compared with BLT in managing end-stage COPD.
Methods: Cochrane, Embase, PubMed, and Scopus were searched for articles by 2 independent reviewers using the Preferred Reporting Items for Systematic Reviews and Meta-analysis system. The review was registered prospectively with PROSPERO (CRD42022343408).
Results: Seven studies of 311 screened met the eligibility criteria, with a total of 10,652 patients with end-stage COPD, SLT (n = 6233), or BLT (n = 4419). Overall survival rates of BLT group were more favorable than SLT group at 1 (odds ratio [OR] = 1.29, 95% CI: 1.16, 1.43, I 2  = 0%), 5 (OR = 1.46, 95% CI: 1.35, 1.58, I 2  = 23%), and 10 years (OR = 1.71, 95% CI: 1.57, 1.87, I 2  = 12%) as well as the hazard ratio (HR = 0.73, 95% CI: 0.70, 0.76, I 2  = 40%). Subgroup analysis on survival rates of alpha-1 antitrypsin deficiency also displayed a trend favoring BLT compared with SLT at 1 (OR = 1.60, 95% CI: 1.24, 2.08, I 2  = 28%), 5 (OR = 1.84, 95% CI: 1.50, 2.26, I 2  = 42%), and 10 years (OR = 1.98, 95% CI: 1.59, 2.48, I 2  = 47%) as well as the HR (HR = 0.67, 95% CI: 0.35, 1.28, I 2  = 82%).
Conclusion: Compared with SLT, BLT seems to demonstrate more favorable trends in survival rates for the management of end-stage COPD. Despite the promising results, the groups have significant heterogeneity in baseline characteristics. Further prospective studies with extended follow-up periods are needed to ascertain the efficacy of treatment.
Competing Interests: Declaration of Competing Interest All the authors declare no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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