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Related Concept Videos

Kidney Transplant I: Introduction01:28

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Updated: Oct 7, 2025

Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
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Lung transplantation for chronic obstructive pulmonary disease: A call to modify the lung allocation score to

Travis D Hull1, Gregory A Leya1, Andrea L Axtell1

  • 1Corrigan Minehan Heart Center and Division of Cardiac Surgery, Massachusetts General Hospital, Boston, Mass; Department of Surgery, Massachusetts General Hospital, Boston, Mass.

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Summary
This summary is machine-generated.

Double lung transplantation (DLT) offers superior survival for COPD patients compared to single lung transplantation (SLT). However, restricted listing preferences increase waitlist mortality, potentially driving SLT use despite DLT

Keywords:
chronic obstruction pulmonary diseasedouble-lung transplantationlung allocation scorelung transplantationsingle-lung transplantationwaitlist mortality

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Area of Science:

  • Pulmonology
  • Transplant Surgery
  • Critical Care Medicine

Background:

  • Chronic obstructive pulmonary disease (COPD) accounts for a significant proportion of lung transplants.
  • Single lung transplantation (SLT) is common for COPD, but double lung transplantation (DLT) may offer better outcomes.
  • Waitlist mortality and posttransplant survival are critical factors in lung allocation for COPD patients.

Purpose of the Study:

  • To compare waitlist mortality between restricted and unrestricted listing preferences in COPD patients.
  • To evaluate posttransplant survival differences between SLT and DLT recipients with COPD.
  • To identify key predictors of mortality in COPD lung transplant candidates.

Main Methods:

  • Retrospective analysis of lung transplant data from the United Network for Organ Sharing database (2005-2018).
  • Inclusion of patients with COPD on the lung transplant waitlist.
  • Comparison of waitlist mortality and posttransplant survival based on listing preference (restricted vs. unrestricted) and transplant type (SLT vs. DLT).

Main Results:

  • Waitlist mortality was higher for patients with restricted DLT preferences (4.39 years) compared to unrestricted (6.09 years).
  • Factors increasing waitlist mortality included female sex, elevated pulmonary artery pressure, and longer wait times.
  • DLT recipients demonstrated superior posttransplant survival (6.5 years) compared to SLT recipients (5.3 years), even after adjustment.

Conclusions:

  • Restricted listing preferences are linked to increased waitlist mortality in COPD patients awaiting lung transplants.
  • Double lung transplantation (DLT) provides significantly better posttransplant survival than single lung transplantation (SLT).
  • The current lung allocation system may lead to suboptimal choices due to concerns about waitlist mortality, despite DLT's survival advantage.