Surgical Complications of Lung Transplantation

Loor, Gabriel; Mattar, Aladdein; Schaheen, Lara; Bremner, Ross M.

doi:10.1016/j.thorsurg.2022.01.003

Cited by 4 publications

(3 citation statements)

References 67 publications

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“…However, it is difficult to reduce the occurrence of sternal dehiscence due to osteomalacia following a long preoperative treatment period, use of high doses of immunosuppressive drugs, and extensive surgical trauma accompanied by ligation of the bilateral mammary artery. 1 2 3 …”

Section: Discussionmentioning

confidence: 99%

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A Comparative Study of a Sternum-Sparing Procedure and Clamshell Incision in Bilateral Lung Transplantation

Park,

Son,

Kim

et al. 2023

Yonsei Med J

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Purpose Clamshell incision offers excellent exposure and access to the pleural spaces and is a standard incision for lung transplantation. However, due to its high sternal complication rate, the clamshell incision is considered a procedure that requires improvement. In this study, we aimed to investigate the outcomes of transverse sternotomy with clamshell incision in comparison to sternum-sparing bilateral anterolateral thoracotomy (BAT). Materials and Methods In total, 134 bilateral sequential lung transplants were performed from May 2013 to June 2022. The clamshell incision was used between May 2013 and December 2017, and the BAT was introduced in January 2018. Thirty-four patients underwent clamshell surgery, and 100 patients underwent BAT. We retrospectively compared patient characteristics and perioperative and postoperative outcomes between the two groups. Results The clamshell group required an operation time of 745.18±101.76 min, which was significantly longer than that of the BAT group at 669.90±134.09 min ( p =0.003). The mechanical ventilation period after surgery was 17.26±16.04 days in the clamshell group, significantly longer than the 11.35±12.42 days in the BAT group ( p =0.028). Intensive care unit stay was also significantly longer in the clamshell group (21.54±15.23 days vs. 15.03±14.28 days; p =0.033). In-hospital mortality rates were 26.5% in the clamshell group and 22.0% in the BAT group. Conclusion Less-invasive lung transplantation via sternum-sparing BAT is a safe procedure with low morbidity and favorable outcomes. Preventing sternal instability enables more stable breathing after surgery, earlier weaning from mechanical ventilation, and faster recovery to routine activities.

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Section: Discussionmentioning

confidence: 99%

“…Although various wiring and transverse sternotomy methods have been used to reduce the incidence of these complications, most of them are complicated and need to be more clearly advantageous, compared to conventional techniques. 1 2 3 …”

Section: Introductionmentioning

confidence: 99%

A Comparative Study of a Sternum-Sparing Procedure and Clamshell Incision in Bilateral Lung Transplantation

Park,

Son,

Kim

et al. 2023

Yonsei Med J

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“…Thus, there are authors who have associated its use with a higher rate of complications [38], while others have reported a lower rejection rate in those patients treated with extracorporeal membrane oxygenation during surgery [39]. In any case, the development of acute rejection could be related to the use of blood products during surgery, the fraction of oxygen required, and the clamping technique [40,41].…”

Section: Discussionmentioning

confidence: 99%

Trends and Outcomes in Lung Transplantation in Patients with and without Idiopathic Pulmonary Fibrosis in Spain during the Period 2016–2020

et al. 2023

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(1) Background: This paper aims to assess temporal trends (2016–2020) in incidence, patient’s characteristics, complications, length of hospital stay (LOHS) and in-hospital mortality (IHM) among patients with and without idiopathic pulmonary fibrosis (IPF) undergoing lung transplantation (LTx). We also analyse the effect of the COVID-19 pandemic on LTx in these populations. (2) Methods: A retrospective, population-based observational study was conducted using the Spanish National Hospital Discharge Database. Multivariable adjustment was conducted with logistic regression to analyse the IHM. (3) Results: We identified 1777 admissions for LTx during the study period, of which 573 (32.2%) were performed in patients with IPF. The number of hospital admissions for LTx rose from 2016 to 2020, both in patients with and without IPF, but a marked reduction was observed from year 2019 to year 2020. Over time, the proportion of single LTx decreased and bilateral LTx increased significantly in both groups. The incidence of LTx complications increased significantly over time along with the increase in the incidence of IPF. No significant differences in the incidence of complications or in the IHM between patients with and without IPF were found. Suffering any complication of the LTx and pulmonary hypertension were conditions positively associated with IHM in patients with and without IPF. The IHM remained stable from 2016 to 2020 in both study populations and was not affected by the COVID pandemic. (4) Conclusions: Patients with IPF account for almost a third of all lung transplants. The number of LTx increased over time in patients with and without IPF, but a marked reduction was observed from 2019 to 2020. Although the proportion of LTx complications increased significantly over time in both groups, the IHM did not change. IPF was not associated with increased complications or IHM after LTx.

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Twenty-Five Years of Lung Transplantation in Medellín: Overcoming the Challenges of an Emerging Country

Vinck

Zapata

Rendón

et al. 2024

Seminars in Thoracic and Cardiovascular Surgery

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Surgical Complications of Lung Transplantation

Cited by 4 publications

References 67 publications

A Comparative Study of a Sternum-Sparing Procedure and Clamshell Incision in Bilateral Lung Transplantation

A Comparative Study of a Sternum-Sparing Procedure and Clamshell Incision in Bilateral Lung Transplantation

Trends and Outcomes in Lung Transplantation in Patients with and without Idiopathic Pulmonary Fibrosis in Spain during the Period 2016–2020

Twenty-Five Years of Lung Transplantation in Medellín: Overcoming the Challenges of an Emerging Country

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