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Single-lung retransplantation for late graft failure
1Service de Pneumologie et Réanimation, INSERM U226, Hôpital Beaujon, Clichy, France.
The European Respiratory Journal
|September 1, 1993
Summary
Single-lung retransplantation in patients with late graft failure shows potential benefits. While early outcomes were poor, long-term survivors achieved stable lung function, suggesting retransplantation is a viable option for selected individuals.
Area of Science:
- Thoracic Surgery
- Transplantation Immunology
- Pulmonary Medicine
Background:
- Graft failure in lung and heart-lung transplant recipients can occur due to chronic rejection, infection, or bronchial complications.
- Retransplantation is an option for graft failure, but early results have been discouraging.
- Late graft failure presents a distinct clinical scenario for retransplantation.
Purpose of the Study:
- To evaluate the feasibility and benefits of single-lung retransplantation in lung transplant recipients experiencing late graft failure.
- To assess functional outcomes and survival rates following retransplantation for chronic lung allograft dysfunction.
Main Methods:
- A series of eight consecutive single-lung retransplantations were performed.
- Patients had prior single-lung (n=7) or double-lung (n=1) transplants.
- Surgical procedures involved removal of the primary graft and native lung in some cases.
Main Results:
- Three patients died within three months post-retransplantation.
- Long-term survivors demonstrated stable forced expiratory volume in one second (FEV1) values averaging 63% predicted.
- Survival ranged from 8 to 20 months for survivors, with four patients alive at the time of reporting.
Conclusions:
- Single-lung retransplantation can be considered for selected patients with late graft failure.
- Functional results in long-term survivors are satisfactory.
- The decision for retransplantation is significantly impacted by donor lung availability.