Double-lung versus heart–lung transplantation for end-stage cardiopulmonary disease: a systematic review and meta-analysis

Yan, Hang; Zheng, Xiangyun; Huang, Heng; Xu, Lin; Tang, Hong-Tao; Wang, Junjie; Li, Cai-Han; Zhang, Sheng-Xuan; Fu, Si-Yi; Wen, Hong-Ying; Tian, Dong

doi:10.1007/s00595-022-02579-4

Cited by 4 publications

(6 citation statements)

References 45 publications

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“…Most studies report similar short and long-term outcomes of patients with progressive end-stage PH after DLTx and HLTx [16,[21][22][23][24]. However, other studies report different post-transplant survival rates [25,26].…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…A systematic review and meta-analysis evaluated short-term and long-term outcomes of patients with end-stage cardiopulmonary disease of different etiologies after DLTx vs. after HLTx, and found no significant differences between DLTx and HLTx patients in 1-, 3-, 5-, and 10-year survival rates [16]. In patients with PAH, DLTx is preferred over single lung transplant [17].…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…In patients with PAH, DLTx is preferred over single lung transplant [17]. DLTx can be considered in patients with PH and recoverable ventricular function, as a rapid reduction in pulmonary resistance after DLTx frequently results in improved right ventricular function [16]. Hadebank et al reported a significant decrease in right ventricular systolic pressure and end-diastolic diameter after DLTx [18].…”

Section: Surgical Treatmentmentioning

confidence: 99%

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Double Lung and Heart-Lung Transplantation for Congenital Heart Disease with Eisenmenger Syndrome and Idiopathic Pulmonary Arterial Hypertension

Knop¹,

Castro-Varela²

2023

New Insights on Pulmonary Hypertension

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Patients with pulmonary hypertension who develop concomitant refractory end-stage lung disease and/or chronic end-stage heart disease should undergo evaluation to determine if they are candidates for double lung (DLTx) or heart-lung transplantation (HLTx). Pulmonary hypertension is the indication for approximately 4.5% of total lung transplants. The most common indication for HLTx is complex congenital heart disease (CHD) with Eisenmenger syndrome. HLTx is also indicated in patients with idiopathic pulmonary arterial hypertension and severe right ventricular (RV) failure. Patients with pulmonary hypertension represent a heterogenous group not only in terms of mechanism leading to the development of pulmonary hypertension but also regarding the presence and degree of right and/or left ventricular dysfunction. The choice between double lung transplant (DLTx) and HLTx is based on the etiology, clinical presentation, and other factors. In this chapter, we will discuss the treatment of patients with CHD with Eisenmenger syndrome and idiopathic pulmonary arterial hypertension, including the surgical option of DLTx and HLTx.

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Section: Surgical Treatmentmentioning

confidence: 99%

Section: Surgical Treatmentmentioning

confidence: 99%

Section: Surgical Treatmentmentioning

confidence: 99%

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Double Lung and Heart-Lung Transplantation for Congenital Heart Disease with Eisenmenger Syndrome and Idiopathic Pulmonary Arterial Hypertension

Knop¹,

Castro-Varela²

2023

New Insights on Pulmonary Hypertension

View full text Add to dashboard Cite

show abstract

“…Yan et al in 2022 based on a meta analysis pointed out that long-term survival, freedom from BOS, and other complications favor combined heart-lung transplantation over double lung transplant. 5 The Cleveland Clinic lung transplant group reported that combined (rather than single) organ transplantation may provide immunoprotective benefits enhancing long-term survival and attenuating the risk of obliterative bronchial disease and chronic transplant vasculopathy. 6 This was true both in comparing lung transplants to heart lung transplants, and heart transplant comparing to heart-lung transplants.…”

mentioning

confidence: 99%

“…The differences were remarkable: 1 year survival with lung transplant alone was 36%, while after combined heart‐lung transplant 62% of the comparable patients were alieve. Yan et al in 2022 based on a meta analysis pointed out that long‐term survival, freedom from BOS, and other complications favor combined heart‐lung transplantation over double lung transplant 5 . The Cleveland Clinic lung transplant group reported that combined (rather than single) organ transplantation may provide immunoprotective benefits enhancing long‐term survival and attenuating the risk of obliterative bronchial disease and chronic transplant vasculopathy 6 .…”

mentioning

confidence: 99%

Should there be an age limit for advanced therapies?

Loebe

Bruckner

2022

Journal of Cardiac Surgery

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Combined heart lung transplant has become a rare procedure. However, there is a significant number of patients potentially benefitting from replacement of both heart and lungs. This represents a quite diverse patient population. Decisions in patient selection have to be adjusted to individual needs and distinct constellation of the patient. Age may be a risk factor, but should be carefully integrated into the evaluation of perioperative and long term risks.

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Outcomes of Multiorgan Heart Transplant Between Donation After Circulatory Death and Brain Death

Endo,

Trivedi,

Moore

et al. 2024

ASAIO Journal

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There is insufficient data on the outcomes of donation after circulatory death (DCD) multiorgan transplant that includes heart. The primary objective of this study is to compare the overall survival outcomes of DCD and donation after brain death (DBD) multiorgan transplants. We identified all heart transplant patients from 2019 to June of 2023 using the United Network for Organ Sharing (UNOS) Database who also received an additional organ (kidney, liver, and lungs). A total of 1,844 DBD and 91 DCD multiorgan transplants occurred within the study period, the majority being combined heart-kidney transplantation. More patients were listed at a higher status in the DBD group (p < 0.05) and were in the intensive care unit (ICU) before transplant (p < 0.05). Despite the higher ischemia time in the DCD group (p < 0.05), the overall unmatched survival did not differ between the two groups (p < 0.05). Within the heart-kidney transplants, the overall survival between DBD and DCD heart-kidney transplants did not differ in either unmatched or matched groups (unmatched p = 0.5, matched p = 0.5). In conclusion, the data on the outcomes of DCD multiorgan transplants are limited. Still, our analysis of the currently available data suggests that the overall survival is comparable in the DCD multiorgan transplants.

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Double-lung versus heart–lung transplantation for end-stage cardiopulmonary disease: a systematic review and meta-analysis

Cited by 4 publications

References 45 publications

Double Lung and Heart-Lung Transplantation for Congenital Heart Disease with Eisenmenger Syndrome and Idiopathic Pulmonary Arterial Hypertension

Double Lung and Heart-Lung Transplantation for Congenital Heart Disease with Eisenmenger Syndrome and Idiopathic Pulmonary Arterial Hypertension

Should there be an age limit for advanced therapies?

Outcomes of Multiorgan Heart Transplant Between Donation After Circulatory Death and Brain Death

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