Postoperative Outcomes and Risk Profiles in Dual Liver-Lung Transplantation: A Single-Center Retrospective Analysis.

Area of Science:

• Transplantation Medicine
• Immunology
• Critical Care Medicine

Background:

• Dual liver-lung transplantation (DLLT) is a rare but vital treatment for patients with end-stage liver and lung disease.
• The complexity and immunosuppression in DLLT can lead to early complications and graft failure.

Purpose of the Study:

• To analyze early and late postoperative events after DLLT.
• To characterize complications such as acute cellular rejection (ACR), infections, malignancy, and readmissions.

Main Methods:

• A retrospective cohort study of 10 adult DLLT recipients from 2013-2024.
• Data collected included demographics, transplant reasons, ischemia times, readmissions, infections, rejection, malignancy, and survival.

Main Results:

• All patients were readmitted within 90 days, primarily for infection (40%).
• Acute cellular rejection (ACR) occurred in 40% of patients, often leading to invasive fungal disease after corticosteroid treatment.
• Infections were common (90% within 6 months), predominantly pulmonary. Malignancy developed in 30% of patients.
• Survival rates were 90% at 1 year, 70% at 3 years, and 60% at 5 years.

Conclusions:

• DLLT is associated with significant early morbidity, including high rates of readmission and infection.
• While short-term survival is favorable, careful management of rejection and infections is crucial.
• Further multicenter research is needed to optimize patient selection and long-term surveillance strategies.