Outcomes from paired single-lung transplants from the same donor

Area of Science:

• Transplantation immunology
• Thoracic surgery

Background:

• Maximizing lung transplant opportunities is crucial.
• Paired single-lung transplants allow direct comparison of left vs. right grafts.
• This approach offers insights into donor vs. recipient factors influencing rejection.

Purpose of the Study:

• To compare outcomes of left and right single-lung transplants from the same donor.
• To investigate the role of donor factors in lung transplant rejection.

Main Methods:

• Analysis of 76 paired single-lung transplants (38 pairs).
• Comparison of outcomes including intensive care unit (ICU) stay, hospital stay, airway complications, and survival rates.
• Assessment of acute and chronic rejection (bronchiolitis obliterans syndrome [BOS]) incidence and severity.

Main Results:

• No significant differences in ICU stay, hospital stay, or 5-year survival between left and right lung transplants.
• Left lung recipients experienced higher mortality at 6 months to 2 years, linked to airway complications.
• Incidence, frequency, and onset of acute and chronic rejection were similar in paired recipients.
• Acute rejection was not correlated with graft ischemic time.

Conclusions:

• General outcomes for right and left lung transplants are comparable.
• Left lung transplantation is associated with increased early-to-mid-term mortality.
• Donor factors do not appear to be the primary drivers of acute rejection or BOS severity in paired lung allografts.