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Right single lung transplantation or double lung transplantation compared with left single lung transplantation in chronic obstructive pulmonary disease.


ABSTRACT:

Background

Although single and double lung transplantation outcomes for chronic obstructive pulmonary disease (COPD) have been investigated, right and left single lung transplants have never been rigorously compared to evaluate disease-specific differences. Single lung transplants for COPD often have hyperinflation of the contralateral native lung, which may be more pronounced in left lung transplants.

Methods

Using the United Network for Organ Sharing registry, we conducted a retrospective cohort study of 5,585 adults who underwent lung transplantation for COPD from May 4, 2005 to June 30, 2017. Subjects were followed until March 2019. Post-transplant survival was compared using Cox proportional hazards and Royston and Parmar's flexible parametric survival models. We adjusted for donor and recipient factors with known or plausible associations with survival.

Results

Lung transplant recipients who received a left single lung transplant for COPD had an increased risk of post-transplant death when compared with those who received a right single lung transplant for COPD (hazard ratio [HR]: 1.24, 95% CI: 1.08-1.48, p?=?0.002). Survival did not differ significantly between double lung transplant and right single lung transplant recipients (HR: 0.88, 95% CI: 0.77-1.02, p?=?0.086). Adjusted 5-year survival was 57.8% (95% CI: 55.7-60.1) for double lung recipients, 56.7% (95% CI: 55.4-58.0) for right single lung recipients, and 50.9% (95% CI: 47.2-55.0) for left single lung recipients.

Conclusions

In COPD, right single lung transplantation was associated with improved post-transplant survival compared with left single lung transplantation, and no significant difference in post-transplant survival compared with double lung transplantation was found. In light of the ongoing donor lung shortage, preferential allocation of right single lungs to patients with COPD should be considered.

SUBMITTER: Benvenuto LJ 

PROVIDER: S-EPMC7863775 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Publications

Right single lung transplantation or double lung transplantation compared with left single lung transplantation in chronic obstructive pulmonary disease.

Benvenuto Luke J LJ   Costa Joseph J   Piloni Davide D   Aversa Meghan M   Anderson Michaela R MR   Shah Lori L   Robbins Hilary Y HY   Stanifer Bryan B   Sonett Joshua R JR   Arcasoy Selim M SM   D'Ovidio Frank F  

The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation 20200624 9


<h4>Background</h4>Although single and double lung transplantation outcomes for chronic obstructive pulmonary disease (COPD) have been investigated, right and left single lung transplants have never been rigorously compared to evaluate disease-specific differences. Single lung transplants for COPD often have hyperinflation of the contralateral native lung, which may be more pronounced in left lung transplants.<h4>Methods</h4>Using the United Network for Organ Sharing registry, we conducted a ret  ...[more]

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