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Published on: October 11, 2024
[Outcomes after singleversus bilateral lung transplantation for idiopathic pulmonary fibrosis]
1Department of Thoracic Surgery, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214000, China.
Objective:
To compare outcomes after single and bilateral lung transplantation in patients with idiopathic pulmonary fibrosis (IPF).
Methods:
104 patients with IPF who underwent lung transplantation at Wuxi People's Hospital from January 2008 to February 2015 were evaluated. Recipients were divided into single lung transplantation (STL)group(41cases)and bilateral lung transplantation(BLT) group (63 cases). Preoperative characteristics, postoperative outcomes, postoperative complications, functional outcomes, survival and causes of death between the two groups were analyzed retrospectively. The patients were followed up by letter, call and outpatient visit.
Results:
Preoperative characteristics: The SLT group were significantly older (P<0.05), and had significantly higher systolic (P<0.05) pulmonary artery pressures than the BLT group. Postoperative outcomes: The intraoperative blood loss of SLT group as significantly less than BLT group (P<0.05). The cold ischemic time of SLT group as significantly shorter than BLT group (P<0.05). The BLT group was significantly more frequently required extracorporeal membrane oxygenation (ECMO) support than SLT group (P<0.05). There was no statistically significant difference inventilator support, reoperation, reintubation, length of ICU stay and death between the SLT and the BLT group (P>0.05). Postoperative complications: The BLT group had a higher incidence of primary graft dysfunction than the SLT group (P<0.05). There was no statistically significant difference in chest complications, acute rejection, airway complications, pulmonary infection between the SLT and the BLT group (P>0.05). Functional outcomes: FVC%, FEV1%, DLCO and 6-MWD, were significantly higher in the BLT group than the SLT group (P<0.05).
Survival:
The overall survival rates at 1, 2 and 3 years were not different between the SLT and the BLT group (75.3%, 61.6% and 46.2% vs 79.1%, 68.6% and 53.4%, P>0.05).
Conclusions:
The lung transplantationis an effective treatment for idiopathic pulmonary fibrosis, BLT could significantly improve the postoperative lung functionin comparison with STL, BLT may be a preferable operation for younger patients, especially if significant pulmonary hypertension is present.The short-term survival of BLT was similar to SLT, but long-term survivalstill needs further follow-up. Considering the quality of life, BLT is better than SLT.
