Comprehensive outcomes after lung retransplantation: A single-center review Academic Article uri icon

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abstract

  • INTRODUCTION: Lung retransplantation is an important therapy for a growing population of lung transplant recipients with graft failure, but detailed outcome data are lacking. METHODS: We conducted a retrospective cohort study of adult lung retransplant in the Toronto Lung Transplant Program from 2001 to 2013 (n = 38). We analyzed the postoperative course, graft function, renal function, microbiology, donor-specific antibodies (DSA), quality of life, and survival compared to a control cohort of primary transplant recipients matched for age and era. RESULTS: Indication for retransplant was chronic lung allograft dysfunction in most retransplant recipients (35/38, 92%). The postoperative course was more complex after retransplant than primary (ventilation time, 8 vs 2 days, P < .01; ICU stay 14 vs 4 days, P < 0.01), and peak lung function was lower (FEV1 2.2L vs 3L, P < .01). Quality of life scores were comparable, as were renal function, microbiology, and donor-specific antibody formation. Median survival was 1988 days after primary and 1475 days after retransplant (P = .39). CONCLUSIONS: Lung retransplantation is associated with a more complex postoperative course and lower peak lung function, but the long-term medical profile is similar to primary transplant. Lung retransplantation can be beneficial for carefully selected candidates with allograft failure.

authors

  • Halloran, Kieran
  • Aversa, Meghan
  • Tinckam, Kathryn
  • Martinu, Tereza
  • Binnie, Matthew
  • Chaparro, Cecilia
  • Chow, Chung-Wai
  • Waddell, Tom
  • McRae, Karen
  • Pierre, Andrew
  • de Perrot, Marc
  • Yasufuku, Kazuhiro
  • Cypel, Marcelo
  • Keshavjee, Shafique
  • Singer, Lianne G

publication date

  • June 2018