Lung Retransplantation for Chronic Rejection: A Single-Center Experience

Roy, Sreeja Biswas; Panchanathan, Roshan; Walia, Rajat; Varsch, Katherine E.; Kang, Paul; Huang, Jasmine; Hashimi, A. Samad; Mohanakumar, Thalachallour; Bremner, Ross M.; Smith, Michael A.

doi:10.1016/j.athoracsur.2017.07.025

Cited by 30 publications

(4 citation statements)

References 27 publications

(38 reference statements)

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“…Regarding stays in the Intensive Care Unit (ICU), a report by Halloran et al found that patients who underwent LRT had extended periods of mechanical ventilation and, as a result, longer stays in the ICU when compared to those who had primary lung transplantation [22]. This finding, however, is in contrast with several other reports, which found no difference in the duration of postoperative mechanical ventilation for both primary transplant and retransplant patients [21,32].…”

Section: Timing To Lung Retransplantation|surgical and Perioperative ...mentioning

confidence: 93%

“…The results of these studies are highly subject to selection bias. [21,22]. Despite pre-LRT status, LRT has been shown to be associated with lower 5-year mortality at ~37% [23].…”

Section: Graft Dysfunction|chronic Lung Allograft Dysfunctionmentioning

confidence: 99%

“…Despite the increased likelihood of being listed for LRT due to recent changes, the relatively stable number of cases performed may be attributed to specific center decisions that limit retransplantation due to increased surgical complexity [7]. Due to reported poorer outcomes for indications such as Primary Graft Dysfunction (PGD) in the setting of acute graft rejection [20], some institutions have implemented policies to only perform LRT for CLAD indications [21].…”

Section: Patient Selection and Evaluationmentioning

confidence: 99%

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Worth a Double Take? An In-Depth Review of Lung Retransplantation

Dawodu,

Gulati,

Bugacov

et al. 2023

JCM

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Provided advancements in Lung Transplantation (LT) survival, the efficacy of Lung Retransplantation (LRT) has often been debated. Decades of retrospective analyses on thousands of LRT cases provide insight enabling predictive patient criteria for retransplantation. This review used the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. The PubMed search engine was utilized for articles relating to LRT published through August 2023, and a systematic review was performed using Covidence software version 2.0 (Veritas Health Innovation, Australia). Careful patient selection is vital for successful LRT, and the benefit leans in favor of those in optimal health following their initial transplant. However, the lack of a standardized approach remains apparent. Through an in-depth review, we will address considerations such as chronic lung allograft dysfunction, timing to LRT, surgical and perioperative complexity, and critical ethical concerns that guide the current practice as it relates to this subset of patients for whom LRT is the only therapeutic option available.

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Section: Timing To Lung Retransplantation|surgical and Perioperative ...mentioning

confidence: 93%

“…The results of these studies are highly subject to selection bias. [21,22]. Despite pre-LRT status, LRT has been shown to be associated with lower 5-year mortality at ~37% [23].…”

Section: Graft Dysfunction|chronic Lung Allograft Dysfunctionmentioning

confidence: 99%

Section: Patient Selection and Evaluationmentioning

confidence: 99%

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Worth a Double Take? An In-Depth Review of Lung Retransplantation

Dawodu,

Gulati,

Bugacov

et al. 2023

JCM

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show abstract

“…Patients who undergo lung re-transplantation have overall worse outcomes as compared to primary lung transplantation, though this is primarily driven by the worse outcomes experienced by patients who undergo re-transplantation early (<1 year after primary lung transplantation) [89] and for the restrictive CLAD phenotype [90]. However, some centers report similar outcomes between primary and re-do lung transplantation in carefully selected patients [91]. In selecting candidates for lung re-transplantation, centers must carefully evaluate their candidates for drivers of CLAD, which include infections, acute rejection/alloimmunization, aspiration/GERD, and medical noncompliance [92].…”

Section: Lung Re-transplantationmentioning

confidence: 99%

Lung Transplantation: Selection of Candidates

Thomas,

Williams,

Shlobin

2023

OBM Transplant

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Lung transplantation is a last-resort treatment option for patients with end stage lung disease. The procedure is being performed more frequently and scientific advances continue to be made, but the median post-transplant survival is far shorter than other solid organ transplant recipients. Candidate selection is a resource intensive process that attempts to balance risks of the procedure with the benefits of much higher quality of life. Transplant centers must weigh disease specific considerations, medical comorbidities, and psychosocial factors with the likelihood of a successful transplantation. While the candidate selection process is exceptionally challenging, it leads to many patients undergoing successful lung transplantation.

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Retransplantation of the Lung(s)

Leiva-Juarez,

D’Ovidio

2024

Organ and Tissue Transplantation

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Lung Retransplantation for Chronic Rejection: A Single-Center Experience

Cited by 30 publications

References 27 publications

Worth a Double Take? An In-Depth Review of Lung Retransplantation

Worth a Double Take? An In-Depth Review of Lung Retransplantation

Lung Transplantation: Selection of Candidates

Retransplantation of the Lung(s)

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