Bilateral versus single lung transplantation for chronic obstructive pulmonary disease: intermediate-term results.
Publication/Presentation Date
12-1-2000
Abstract
BACKGROUND: There is controversy regarding the transplant procedure of choice in chronic obstructive pulmonary disease. We reviewed our intermediate-term outcomes with single lung transplantation (SLT) versus bilateral lung transplantation (BLT).
METHODS: We retrospectively reviewed 130 patients with chronic obstructive pulmonary disease: 84 underwent SLT, 46 BLT. The mean age was 51.1 +/- 1.2 years for those who underwent BLT and 56.2 +/- 0.7 years for those who underwent SLT (p < 0.0001). Male patients represented 65% of the BLT group and 46% of the SLT group (p = 0.04). Spirometry and 6-minute walk tests were obtained preoperatively and at 3- to 6-month intervals. Posttransplant survival and survival from time of onset of bronchiolitis obliterans syndrome were calculated by Kaplan-Meier method. The mean follow-up was 32.4 months.
RESULTS: The 90-day mortality rate was 13.0% For BLT and 15.5% for SLT (p = 0.71). Actuarial survival rates at 1, 3, and 5 years were 82.6%, 74.6%, and 61.9% for BLT and 72.2%, 63.4%, and 57.4% for SLT; the favorable survival trend with BLT did not achieve statistical significance. There were no differences in preoperative spirometry or 6-minute walk tests. The improvements in forced expiratory volume in one second, forced vital capacity (FVC), and 6 MWT were significantly greater following BLT. The incidence of bronchiolitis obliterans syndrome was 22.4% in SLT and 22.2% in BLT; survival following onset of bronchiolitis obliterans syndrome was similar.
CONCLUSIONS: For patients with chronic obstructive pulmonary disease, BLT is associated with superior lung function, exercise tolerance, and a trend toward enhanced survival. Younger candidates may be best suited for BLT. Given the limited donor lungs, SLT remains the preferred alternative for all other patients.
Volume
70
Issue
6
First Page
1813
Last Page
1818
ISSN
0003-4975
Published In/Presented At
Pochettino, A., Kotloff, R. M., Rosengard, B. R., Arcasoy, S. M., Blumenthal, N. P., Kaiser, L. R., & Bavaria, J. E. (2000). Bilateral versus single lung transplantation for chronic obstructive pulmonary disease: intermediate-term results. The Annals of thoracic surgery, 70(6), 1813–1819. https://doi.org/10.1016/s0003-4975(00)01970-6
Disciplines
Medicine and Health Sciences
PubMedID
11156077
Department(s)
Department of Surgery
Document Type
Article