Single versus bilateral lung transplantation for idiopathic pulmonary fibrosis

Lung transplantation, either single or bilateral, serves as the only effective treatment for end-stage idiopathic pulmonary fibrosis (IPF), but their superiority is still being debated, and its application in Chinese patients has not been data analysed.

We reviewed 109 IPF patients who received lung transplantation at our centre between January 1, 2015 and December 31, 2017. The patients were divided into single lung transplantation (SLT) group and bilateral lung transplantation (BLT) group. We compared the two groups' demographic characteristics and clinical indexes (intraoperative conditions, postoperative complications, follow-ups and life qualities).

Patients in BLT group were significantly younger than those in SLT group (P < 0.001), and had more pretransplant infections (P = 0.007). The total ischemic time (P < 0.001) was shorter and intraoperative blood loss was less (P = 0.001) in SLT group. No significant difference was found in the proportion of patients in using anti-fibrosis drugs, pulmonary artery pressure, extracorporeal membrane oxygenation during the surgery; the length of intensive care unit stay; the incidence of complication; and the overall survival rate between two groups. However, the hierarchical analysis found that patients aged > 60 years showed a better survival in SLT group (P = 0.008). Both groups got normal MOS 36-item Short Form (SF-36) scores, and the scores of BLT were higher than those of SLT. The BLT group had better lung function than SLT group 1 year post-lung transplantation.

Both SLT and BLT are effective and SLT is more favourable for the patients of > 60 years.