Retransplantation After Single Lung Transplantation

Sakornpant, Pantpis; Kasemsarn, Choosak; Yottasurodom, Chaiwut

doi:10.1016/j.transproceed.2008.07.120

Cited by 6 publications

(3 citation statements)

References 5 publications

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“…This approach, in our experience, has no impact on patient survival or complications, may alleviate donor organ shortage, and contributes to decreasing morbidity and mortality on the national waiting list. In addition, this approach also allows contralateral transplantation, if needed to solve future complications [36] .…”

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%

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

Borro¹,

Delgado²,

Coll³

et al. 2016

WJT

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“…Sirolimus blokuje mTORC1, a tím snižuje proliferaci a zmenšuje velikost buněk. [48][49][50][51]. Jsou známy zkušenosti s retransplantací plic pro selhání štěpu nebo při recidivě plicního postižení v transplantátu [50,51].…”

Section: Schéma 1 Signalizační Dráha Mtor a Působení Inhibitoru Mtorunclassified

Lymphangioleiomyomatosis

Doubková¹,

Štefániková²,

Čan³

et al. 2019

Klin Onkol

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a tuberkulózy LF MU a FN Brno 2 Chirurgická klinika LF MU a FN Brno 3 Klinika komplexní onkologické péče, Masarykův onkologický ústav, Brno 4 Oddělení epidemiologie a genetiky nádorů, Masarykův onkologický ústav, Brno Souhrn Východiska: Lymfangioleiomyomatóza (LAM) je vzácné systémové onemocnění, které se vyskytuje sporadicky (S/ LAM) nebo je součástí tuberózní sklerózy (TS/ LAM). Onemocnění je charakterizováno proliferací abnormálních buněk hladkého svalstva. LAM se klinicky manifestuje zhoršující se námahovou dušností a pneumotoraxy. Bývá zvětšení uzlin v abdominální a pánevní oblasti vedoucí k lymfatické obstrukci. LAM je asociována s angiomyolipomy v ledvinách. Dia gnóza je stanovena histologicky a/ nebo kombinací anamnézy a typického nálezu při vyšetření plic výpočetní tomografií s vysokým rozlišením. V histopatologickém nálezu je dia gnóza podporována nálezem charakteristických LAM buněk. Je to onemocnění progredující, s možností kauzální léčby inhibitory mTOR. Materiál a metody: Na našem pracovišti bylo v letech 2002-2018 sledováno celkem deset pacientek s LAM (osm S/ LAM, dvě TS/ LAM) a plicním postižením. Popisujeme jednotlivé klinické charakteristiky a naše zkušenosti s léčbou. Výsledky: LAM je prezentována na deseti případech s různým stupněm pokročilosti. Stanovení prognózy u konkrétního nemocného s plicní formou LAM je těžké. Nejlepším ukazatelem vývoje onemocnění je sledování hodnot plicních funkčních parametrů (usilovná vitální kapacita, usilovně vydechnutý objem za první sekundu, difuzní kapacita plic) v čase. V současné době jsou léčeni čtyři naši pacienti mTOR inhibitory, u všech vedla terapie ke stabilizaci plicních funkčních parametrů. Medián sledování byl 48 měsíců (12-132). Nebyl dosažen medián přežití, zemřeli jen tři pacienti. Závěr: Společná mezioborová spolupráce pneumologa, chirurga, onkologa a genetika je základem naší péče o pacientky s LAM. Terapie inhibitory mTOR vedla ke stabilizaci LAM u našich nemocných. Nežádoucí účinky léčby byly dobře zvládnutelné.

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“…5) If the patient is with severe graft dysfunction while there is no other therapy that can prolong life, lung retransplantation is the only treatment option. However, retransplantation has the potential to add increased, surgical risks.…”

Section: Discussionmentioning

confidence: 99%

Right Native Lung Pneumonectomy Due to over Inflation Three Years after Left Single Lung Transplantation for Pulmonary Lymphangioleiomyomatosis

Liu

Ruan

Wang

et al. 2014

Ann Thorac Cardiovasc Surg

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Native lung hyperinflation (NLH) is one of the known complications after single lung transplantation (SLT). Generally, satisfactory results are achieved in patients undergoing SLT when simultaneous (or second stage) volume reduction of the contralateral native lung is performed. Contralateral native lung pneumonectomy after SLT is rarely reported. In this article, we report a case of a successful, right pneumonectomy of the native lung, 3 years after a left single lung transplant for pulmonary lymphangioleiomyomatosis (PLAM). The patient's pulmonary function and quality of life improved significantly after a right pneumonectomy of the native lung.

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Retransplantation After Single Lung Transplantation

Cited by 6 publications

References 5 publications

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

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

Lymphangioleiomyomatosis

Right Native Lung Pneumonectomy Due to over Inflation Three Years after Left Single Lung Transplantation for Pulmonary Lymphangioleiomyomatosis

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