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Staging of Bilateral Lung Transplantation for High-Risk Patients With Interstitial Lung Disease: One Lung at a Time.

Publication ,  Journal Article
Hartwig, MG; Ganapathi, AM; Osho, AA; Hirji, SA; Englum, BR; Speicher, PJ; Palmer, SM; Davis, RD; Snyder, LD
Published in: Am J Transplant
November 2016

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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Published In

Am J Transplant

DOI

EISSN

1600-6143

Publication Date

November 2016

Volume

16

Issue

11

Start / End Page

3270 / 3277

Location

United States

Related Subject Headings

  • Time Factors
  • Survival Rate
  • Surgery
  • Risk Assessment
  • Retrospective Studies
  • Respiratory Function Tests
  • Prognosis
  • Postoperative Complications
  • Middle Aged
  • Male
 

Citation

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MLA
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Hartwig, M. G., Ganapathi, A. M., Osho, A. A., Hirji, S. A., Englum, B. R., Speicher, P. J., … Snyder, L. D. (2016). Staging of Bilateral Lung Transplantation for High-Risk Patients With Interstitial Lung Disease: One Lung at a Time. Am J Transplant, 16(11), 3270–3277. https://doi.org/10.1111/ajt.13892
Hartwig, M. G., A. M. Ganapathi, A. A. Osho, S. A. Hirji, B. R. Englum, P. J. Speicher, S. M. Palmer, R. D. Davis, and L. D. Snyder. “Staging of Bilateral Lung Transplantation for High-Risk Patients With Interstitial Lung Disease: One Lung at a Time.Am J Transplant 16, no. 11 (November 2016): 3270–77. https://doi.org/10.1111/ajt.13892.
Hartwig MG, Ganapathi AM, Osho AA, Hirji SA, Englum BR, Speicher PJ, et al. Staging of Bilateral Lung Transplantation for High-Risk Patients With Interstitial Lung Disease: One Lung at a Time. Am J Transplant. 2016 Nov;16(11):3270–7.
Hartwig, M. G., et al. “Staging of Bilateral Lung Transplantation for High-Risk Patients With Interstitial Lung Disease: One Lung at a Time.Am J Transplant, vol. 16, no. 11, Nov. 2016, pp. 3270–77. Pubmed, doi:10.1111/ajt.13892.
Hartwig MG, Ganapathi AM, Osho AA, Hirji SA, Englum BR, Speicher PJ, Palmer SM, Davis RD, Snyder LD. Staging of Bilateral Lung Transplantation for High-Risk Patients With Interstitial Lung Disease: One Lung at a Time. Am J Transplant. 2016 Nov;16(11):3270–3277.
Journal cover image

Published In

Am J Transplant

DOI

EISSN

1600-6143

Publication Date

November 2016

Volume

16

Issue

11

Start / End Page

3270 / 3277

Location

United States

Related Subject Headings

  • Time Factors
  • Survival Rate
  • Surgery
  • Risk Assessment
  • Retrospective Studies
  • Respiratory Function Tests
  • Prognosis
  • Postoperative Complications
  • Middle Aged
  • Male