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Staging of Bilateral Lung Transplantation for High-Risk Patients With Interstitial Lung Disease: One Lung at a Time.
Hartwig, M G; Ganapathi, A M; Osho, A A; Hirji, S A; Englum, B R; Speicher, P J; Palmer, S M; Davis, R D; Snyder, L D.
Afiliación
  • Hartwig MG; Department of Surgery, Duke University Medical Center, Durham, NC. matthew.hartwig@duke.edu.
  • Ganapathi AM; Department of Surgery, Duke University Medical Center, Durham, NC.
  • Osho AA; Department of Surgery, Duke University Medical Center, Durham, NC.
  • Hirji SA; Department of Surgery, Duke University Medical Center, Durham, NC.
  • Englum BR; Department of Surgery, Duke University Medical Center, Durham, NC.
  • Speicher PJ; Department of Surgery, Duke University Medical Center, Durham, NC.
  • Palmer SM; Department of Medicine, Duke University Medical Center, Durham, NC.
  • Davis RD; Department of Surgery, Duke University Medical Center, Durham, NC.
  • Snyder LD; Department of Medicine, Duke University Medical Center, Durham, NC.
Am J Transplant ; 16(11): 3270-3277, 2016 11.
Article en En | MEDLINE | ID: mdl-27233085
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Trasplante de Pulmón / Enfermedades Pulmonares Intersticiales / Supervivencia de Injerto / Tiempo de Internación Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2016 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Trasplante de Pulmón / Enfermedades Pulmonares Intersticiales / Supervivencia de Injerto / Tiempo de Internación Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2016 Tipo del documento: Article Pais de publicación: Estados Unidos