Single lung transplantation for pulmonary fibrosis: Does side matter?

Area of Science:

• Thoracic surgery
• Transplantation immunology
• Pulmonary medicine

Background:

• Lung Allocation Score implementation reduced waiting list mortality but organ shortage persists.
• Single lung transplantation (sLTx) is a strategy to decrease waiting list mortality.
• sLTx has been consistently used for pulmonary fibrosis patients.

Purpose of the Study:

• To analyze the long-term outcomes of sLTx in pulmonary fibrosis patients.
• To determine if the side of sLTx impacts patient outcomes.

Main Methods:

• Retrospective analysis of 138 sLTx procedures performed between 1995 and 2024.
• Patients had pulmonary fibrosis (mean age 54 ± 9 years, 88% male).
• Comparison of outcomes between left sLTx (n=98) and right sLTx (n=40).

Main Results:

• Overall survival rates were 83% (1 year), 59% (5 years), and 29% (10 years).
• Survival rates were similar for left and right sLTx at all time points (p=0.54).
• Postoperative pneumonia and sepsis were predictors of early mortality.

Conclusions:

• sLTx is an effective strategy for pulmonary fibrosis patients, optimizing donor organ use.
• Outcomes are acceptable and not dependent on the side of the lung transplanted.
• Further research into early mortality predictors like pneumonia and sepsis is warranted.