Staging of Bilateral Lung Transplantation for High-Risk Patients With Interstitial Lung Disease: One Lung at a Time
| Autor: | Scott M. Palmer, Asishana A. Osho, Sameer A. Hirji, Matthew G. Hartwig, Brian R. Englum, Paul J. Speicher, Asvin M. Ganapathi, Robert D. Davis, Laurie D. Snyder |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment 030204 cardiovascular system & hematology Risk Assessment Article Pulmonary function testing 03 medical and health sciences Postoperative Complications 0302 clinical medicine medicine Humans Immunology and Allergy Lung transplantation Pharmacology (medical) Survival rate Aged Retrospective Studies Transplantation Lung business.industry Graft Survival Interstitial lung disease Retrospective cohort study Length of Stay Middle Aged respiratory system Prognosis medicine.disease Respiratory Function Tests Surgery Survival Rate medicine.anatomical_structure 030228 respiratory system Female Lung Diseases Interstitial business Risk assessment Follow-Up Studies Lung Transplantation Lung allocation score |
| Zdroj: | American Journal of Transplantation. 16:3270-3277 |
| ISSN: | 1600-6135 |
| DOI: | 10.1111/ajt.13892 |
| Popis: | The choice of a single or bilateral lung transplant for interstitial lung disease (ILD) is controversial, as surgical risk, long-term survival and organ allocation are competing factors. In an effort to balance risk and benefit, our center adopted a staged bilateral lung transplant approach for higher surgical risk ILD patients where the patient has a single lung transplant followed by a second single transplant at a later date. We sought to understand the surgical risk, organ allocation and early outcomes of these staged bilateral recipients as a group and in comparison to matched single and bilateral recipients. Our analysis demonstrates that staged bilateral lung transplant recipients (n = 12) have a higher lung allocation score (LAS), lower pulmonary function tests and a lower glomerular filtration rate prior to the first transplant compared to the second (p < 0.01). There was a shorter length of hospital stay for the second transplant (p = 0.02). The staged bilateral compared to the single and bilateral case-matched controls had comparable short-term survival (p = 0.20) and pulmonary function tests at 1 year. There was a higher incidence of renal injury in the conventional bilateral group compared to the single and staged bilateral groups. The staged bilateral procedure is a viable option in select ILD patients. |
| Databáze: | OpenAIRE |
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