Lung transplantation for ventilator-dependent respiratory failure

Area of Science:

• Cardiothoracic surgery
• Pulmonary medicine
• Transplant surgery

Background:

• Lung transplantation for patients on mechanical ventilation is debated.
• Successful outcomes have been reported, prompting further investigation.
• This study details institutional experience with lung transplants in mechanically ventilated patients since 2003.

Purpose of the Study:

• To evaluate the feasibility and outcomes of lung transplantation in patients requiring mechanical ventilation.
• To compare the clinical course and survival of mechanically ventilated lung transplant recipients with non-ventilated recipients.

Main Methods:

• Retrospective cohort study of adult lung transplant recipients (October 2003 - October 2007).
• Comparison of patients on mechanical ventilation pre-transplant versus those not on mechanical ventilation.
• Analysis of survival, ICU and hospital length of stay, post-transplant mechanical ventilation duration, and primary graft function.

Main Results:

• 15 patients received mechanical ventilation pre-transplant; 13 underwent transplantation.
• Mechanically ventilated patients had a shorter waiting time for transplantation.
• No significant differences in survival or primary graft dysfunction were observed between groups.
• Mechanically ventilated patients experienced longer post-transplant mechanical ventilation and ICU stays.

Conclusions:

• Lung transplantation is a viable option for patients with respiratory failure requiring mechanical ventilation.
• Outcomes for these patients are comparable to other lung transplant candidates.
• While post-operative care may be extended, survival and graft function are not compromised.