Results of “Twinning Procedure” in Lung Transplantation: Experience in a Single Center

Torre, Mario; Borro, J.M.; Fernández, Ramiro; González, D.; Delgado, Manuel; Paradela, Marina; García, Jorge A.; Lemos, C.

doi:10.1016/j.transproceed.2009.05.018

Cited by 2 publications

(1 citation statement)

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“…Figure 5 shows how our preference for SL has clearly reduced the median number of waiting list days, compared to the rest of Spanish hospitals performing this procedure. In addition, our policy of performing preferably SL has led to the implementation of the "twinning procedure", 2 SL performed simultaneously from 1 donor [35] . Twinning in the same hospital has been shown to be feasible with adequate planning, permitting better use of donors and reducing waiting list time and mortality.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

confidence: 99%