Results of Lung Transplantation in Patients With Chronic Obstructive Pulmonary Disease

Cano, Juan; Algar, Francisco Javier Algar; Cerezo, Francisco; Moreno, Paula; Espinosa, Dionisio; Álvarez, Antonio; Baamonde, C.; Santos, Francisco; Salvatierra, A.

doi:10.1016/j.transproceed.2008.09.004

Cited by 5 publications

(5 citation statements)

References 9 publications

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“…Hence, it is necessary for the organ donation coordinator to confirm the family’s willingness to donate in order to save invalid travel and avoid the waste of time and human resources. Owing to family hesitancy, the complicated process of brain death diagnosis, and time spent on gathering an organ procurement team by the OPO, the median time of tracheal intubation in this study was 5.5 days (IQR 4–8 days), which was significantly longer than what was reported by centers in other countries (usually 1–3 days) [ 16 , 19 , 20 ]. Long-term intubation is more likely to cause infection and hypoxemia [ 21 ], posing difficulties in management.…”

Section: Discussioncontrasting

confidence: 53%

The Low Utilization Rate of Donor Lungs in China: A Single-Center Experience

et al. 2021

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Background Despite the increasing number of organ donations, the utilization rate of donor lungs in China is much lower than that in many other countries. Material/Methods The donor lungs were evaluated before departure (stage 1), after on-site management (stage 2), and after harvesting (stage 3). Variables of donor lungs from medical institutions with lung transplant qualification (group A) and those without qualification (group B) were compared. The outcome measurements for lung recipients were early survival and primary graft dysfunction. Results Among the 277 donor lungs, 140 (51%) were suitable for transplantation and 101 were sent to our institution for 62 single-lung transplantations and 50 double-lung transplantations. The acceptability rates at stage 1, stage 2, and stage 3 were 78%, 56%, and 51%, respectively. In addition, 69 (50.4%) donor lungs were abandoned for poor quality related to management, 24 (17.5%) for no adequate recipients, 15 (10.9%) for family refusal, 14 (10.2%) for organ procurement organization-related reasons, and 15 (10.9%) for other reasons. Donors in group A were ventilated longer and had longer ischemic time than those in group B. However, bronchoscopy, imaging, and oxygenation in group A achieved better results than in group B. No between-group difference in 30-day mortality or rate of grade 3 primary graft dysfunction was observed. Conclusions Problems at supply and demand ends contribute to the low utilization rate of donor lungs in China. The poor management of donor lungs and the short waiting list for lung transplantation are major reasons.

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Section: Discussioncontrasting

confidence: 53%

The Low Utilization Rate of Donor Lungs in China: A Single-Center Experience

et al. 2021

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“…In our series, lung volume reduction surgery was performed in 4 patients with generally good results, and increasing numbers of centers are implementing techniques such as VATS and endobronchial valves [25][26][27][28] . In the present clinical setting, the possibility of appropriately controlling this complication is high, and, moreover, SL is technically simpler, anatomically less aggressive, and involves shorter total ischemia time [5] , which would explain the lower perioperative morbidity and mortality rates in our series. Furthermore, recent techniques such as normothermic ex vivo lung perfusion systems may allow the conservation and transplant of lungs in optimal conditions, likely improving the present results [29,30] .…”

Section: Discussionmentioning

confidence: 82%

“…In 2011, 29.5% of advanced emphysema patients were in need of this intervention, 26.2% of whom had chronic obstructive pulmonary disease (COPD) type 1, and 3.3% α1-antitrypsin deficiency [4] . The question remains whether single or double-lung transplantation should be performed [5][6][7][8][9] . Single-lung transplantation (SL) has the advantage of making optimal use of available organs, but some studies indicate better outcomes and survival in patients with double-lung transplant (DL) compared to SL recipients [8,10] .…”

Section: Introductionmentioning

confidence: 99%

Single-lung transplantation in emphysema: Retrospective study analyzing survival and waiting list mortality

Borro¹,

Delgado²,

Coll³

et al. 2016

WJT

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AIM:To performed remains a subject of debate and is the principal aim of the study. METHODS:This retrospective analysis included 73 patients with emphysema (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012). The outcomes of patients undergoing single-lung transplantation (SL) (n = 40) or double-lung transplant (DL) (n = 33) were compared in a Cox multivariate analysis to study the impact of the technique, postoperative complications and acute and chronic rejection on survival rates. Patients were selected for inclusion in the waiting list according to the International Society of Heart Lung Transplantation criteria. Pre and postoperative rehabilitation and prophylaxis, surgical technique and immunosuppressive treatment were similar in every patients. Lung transplantation waiting list information on a national level and retrospective data on emphysema patient survival transplanted in Spain during the study period, was obtained from the lung transplantation registry managed by the National Transplant Organization (ONT). RESULTS:Both groups were comparable in terms of gender and clinical characteristics. We found significant differences in the mean age between the groups, the DL patients being younger as expected from the inclusion criteria. Perioperative complications occurred in 27.6% SL vs 54% DL (P = 0.032). Excluding perioperative mortality, median survival was 65.3 mo for SL and 59.4 mo for DL (P = 0.96). Bronchiolitis obliterans and overall 5-year survival were similar in both groups. Bacterial Core tip: This is a retrospective and comparative study of 2 cohort of patients with advanced-stage emphysema who were performed uni or bilateral lung transplant. The results of this study support the realization of singlelung transplantation in most of the cases of emphysema because it is technically simpler, it has less risk of surgical sutures, and finally it has less immediate postoperative complications. Single and double lung transplantation has a similar long-term survival. Moreover, if a second transplant is needed in the long-term, the contralateral transplantation has the same initial transplant survival if the patient remains in a similar clinical situation. Survival Spanish national register does not show difference between the two techniques too, supporting the results of our relatively small series. This strategy of performing single lung transplantation in most of the cases of emphysema would encourage and enhance the use of donors thanks to the twining procedure, and would decrease mortality in the waiting list as shown in the National Transplant Organization patients analysed. Proper pre and postoperative prophylaxis and postoperative early extubation protocol is essential to achieve good results.Borro JM, Delgado M, Coll E, Pita S. Singlelung transplantation in emphysema: Retrospective study analyzing survival and waiting list mortality. World J Transplant 2016; 6(2): 347355 Available from:

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“…[144] Lung transplantation results in improvement in exercise capacity, quality of life, and lung functions; however, controversy remains regarding survival benefit. [145146]…”

Section: Non-pharmacological Therapiesmentioning

confidence: 99%

The Saudi guidelines for the diagnosis and management of COPD

Khan¹,

Lababidi²,

Al-Moamary³

et al. 2014

Ann Thorac Med

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The Saudi Thoracic Society (STS) launched the Saudi Initiative for Chronic Airway Diseases (SICAD) to develop a guideline for the diagnosis and management of chronic obstructive pulmonary disease (COPD). This guideline is primarily aimed for internists and general practitioners. Though there is scanty epidemiological data related to COPD, the SICAD panel believes that COPD prevalence is increasing in Saudi Arabia due to increasing prevalence of tobacco smoking among men and women. To overcome the issue of underutilization of spirometry for diagnosing COPD, handheld spirometry is recommended to screen individuals at risk for COPD. A unique feature about this guideline is the simplified practical approach to classify COPD into three classes based on the symptoms as per COPD Assessment Test (CAT) and the risk of exacerbations and hospitalization. Those patients with low risk of exacerbation (<2 in the past year) can be classified as either Class I when they have less symptoms (CAT < 10) or Class II when they have more symptoms (CAT ≥ 10). High-risk COPD patients, as manifested with ≥2 exacerbation or hospitalization in the past year irrespective of the baseline symptoms, are classified as Class III. Class I and II patients require bronchodilators for symptom relief, while Class III patients are recommended to use medications that reduce the risks of exacerbations. The guideline recommends screening for co-morbidities and suggests a comprehensive management approach including pulmonary rehabilitation for those with a CAT score ≥10. The article also discusses the diagnosis and management of acute exacerbations in COPD.

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Results of Lung Transplantation in Patients With Chronic Obstructive Pulmonary Disease

Cited by 5 publications

References 9 publications

The Low Utilization Rate of Donor Lungs in China: A Single-Center Experience

The Low Utilization Rate of Donor Lungs in China: A Single-Center Experience

Single-lung transplantation in emphysema: Retrospective study analyzing survival and waiting list mortality

The Saudi guidelines for the diagnosis and management of COPD

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