Clinical features and outcomes of unplanned single lung transplants
Copyright © 2022 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved..
OBJECTIVE: The decision to perform single lung transplants or double lung transplants is usually made before the operation. We have previously reported that a proportion of single lung transplants were unexpectedly performed in the setting of an aborted double lung transplant, and these patients may be at a higher risk of worse short-term outcomes. Long-term outcomes in unplanned single lung transplants remain unknown.
METHODS: We analyzed a single-center database of lung transplants from 2000 to 2020. Single lung transplants were classified into planned and unplanned groups after reviewing operative notes. Root cause analysis was performed for unplanned single lung transplants.
RESULTS: Of the 1326 lung transplants, 1265 (95%) were double lung transplants and 61 (5%) were single lung transplants (22 planned [36%], 39 unplanned [64%]). Underlying indications for transplant were significantly different; planned single lung transplant: chronic obstructive pulmonary disease (55%) and idiopathic pulmonary fibrosis (45%); unplanned single lung transplants: chronic obstructive pulmonary disease (23%), idiopathic pulmonary fibrosis (39%), and bronchiolitis obliterans syndrome (13%). The primary reasons for unplanned single lung transplant were donor-related (3, 7.7%), recipient-related (31, 80%), and donor and recipient-related factors (5, 13%). Unplanned single lung transplants were more likely to require cardiopulmonary bypass during the operation (planned: 4/22, 18% vs unplanned: 20/39, 51%) but had shorter ischemic times (planned: 251 ± 58 minutes vs unplanned: 221 ± 48 minutes). The 5-year overall survival was 53% in the planned and 58% in the unplanned groups, respectively (P = .323). No difference in chronic lung allograft dysfunction-free survival (P = .995) was observed.
CONCLUSIONS: Unplanned single lung transplants in the setting of aborted double lung transplant may be associated with acceptable long-term outcomes.
| Errataetall: |
CommentIn: J Thorac Cardiovasc Surg. 2022 Dec;164(6):1660. - PMID 35248357 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:164 |
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| Enthalten in: |
The Journal of thoracic and cardiovascular surgery - 164(2022), 6 vom: 27. Dez., Seite 1650-1659.e3 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Terada, Yuriko [VerfasserIn] |
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| Links: |
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| Themen: |
Double lung transplantation |
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| Anmerkungen: |
Date Completed 16.11.2022 Date Revised 16.11.2022 published: Print-Electronic CommentIn: J Thorac Cardiovasc Surg. 2022 Dec;164(6):1660. - PMID 35248357 Citation Status MEDLINE |
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| doi: |
10.1016/j.jtcvs.2022.01.055 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Clinical features and outcomes of unplanned single lung transplants |
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| 500 | |a Date Completed 16.11.2022 | ||
| 500 | |a Date Revised 16.11.2022 | ||
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| 500 | |a CommentIn: J Thorac Cardiovasc Surg. 2022 Dec;164(6):1660. - PMID 35248357 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: The decision to perform single lung transplants or double lung transplants is usually made before the operation. We have previously reported that a proportion of single lung transplants were unexpectedly performed in the setting of an aborted double lung transplant, and these patients may be at a higher risk of worse short-term outcomes. Long-term outcomes in unplanned single lung transplants remain unknown | ||
| 520 | |a METHODS: We analyzed a single-center database of lung transplants from 2000 to 2020. Single lung transplants were classified into planned and unplanned groups after reviewing operative notes. Root cause analysis was performed for unplanned single lung transplants | ||
| 520 | |a RESULTS: Of the 1326 lung transplants, 1265 (95%) were double lung transplants and 61 (5%) were single lung transplants (22 planned [36%], 39 unplanned [64%]). Underlying indications for transplant were significantly different; planned single lung transplant: chronic obstructive pulmonary disease (55%) and idiopathic pulmonary fibrosis (45%); unplanned single lung transplants: chronic obstructive pulmonary disease (23%), idiopathic pulmonary fibrosis (39%), and bronchiolitis obliterans syndrome (13%). The primary reasons for unplanned single lung transplant were donor-related (3, 7.7%), recipient-related (31, 80%), and donor and recipient-related factors (5, 13%). Unplanned single lung transplants were more likely to require cardiopulmonary bypass during the operation (planned: 4/22, 18% vs unplanned: 20/39, 51%) but had shorter ischemic times (planned: 251 ± 58 minutes vs unplanned: 221 ± 48 minutes). The 5-year overall survival was 53% in the planned and 58% in the unplanned groups, respectively (P = .323). No difference in chronic lung allograft dysfunction-free survival (P = .995) was observed | ||
| 520 | |a CONCLUSIONS: Unplanned single lung transplants in the setting of aborted double lung transplant may be associated with acceptable long-term outcomes | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a double lung transplantation | |
| 650 | 4 | |a lung transplantation | |
| 650 | 4 | |a single lung transplantation | |
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| 700 | 1 | |a Hachem, Ramsey R |e verfasserin |4 aut | |
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