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Open Access 01-12-2024 | Chronic Obstructive Lung Disease | Research

Double lung transplantation is better than single lung transplantation for end-stage chronic obstructive pulmonary disease: a meta-analysis

Authors: Yu-Chi Fang, Wen-Hsin Cheng, Hung-I Lu, Yi-Shi Wang, Kai-Hao Chuang, Hsing-Hua Lai, Yu Chen, Li-Chun Chen, Meng-Yun Tsai, Yu-Ping Chang, Kuo-Tung Huang, Chien-Ming Lo

Published in: Journal of Cardiothoracic Surgery | Issue 1/2024

Abstract

Background

Lung transplantation is one of the most common treatment options for patients with end-stage chronic obstructive pulmonary disease. However, the choice between single and double lung transplantation for these patients remains a matter of debate. Therefore, we performed a systematic search of medical databases for studies on single lung transplantation, double lung transplantation, and chronic obstructive pulmonary disease.

Methods

The rate ratio and hazard ratio of survival were analyzed. The meta-analysis included 15 case–control and retrospective registry studies.

Results

The rate ratios of the 3-year survival (0.937 and P = 0.041) and 5-year survival (0.775 and P = 0.000) were lower for single lung transplantation than for double lung transplantation. However, the hazard ratio did not differ significantly between the two.

Conclusions

Double lung transplantation was found to provide better benefits than single lung transplantation in terms of the long-term survival in patients with chronic obstructive pulmonary disease.

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Pochettino A, Kotloff RM, Rosengard BR, Arcasoy SM, Blumenthal NP, Kaiser LR, et al. Bilateral versus single lung transplantation for chronic obstructive pulmonary disease: intermediate-term results. Ann Thorac Surg. 2000;70(6):1813–8; discussion 8-9.CrossRefPubMed

Thabut G, Christie JD, Ravaud P, Castier Y, Brugière O, Fournier M, et al. Survival after bilateral versus single lung transplantation for patients with chronic obstructive pulmonary disease: a retrospective analysis of registry data. Lancet (London, England). 2008;371(9614):744–51.CrossRefPubMed

Moffatt SD, Demers P, Robbins RC, Doyle R, Wienacker A, Henig N, et al. Lung transplantation: a decade of experience. J Heart Lung Transplant. 2005;24(2):145–51.CrossRefPubMed

Thacker J, Toyoda Y. Lung and heart-lung transplantation at University of Pittsburgh: 1982–2009. Clinical transplants. 2009:179–95.

Jesel L, Barraud J, Lim HS, Marzak H, Messas N, Hirschi S, et al. Early and late atrial arrhythmias after lung transplantation- incidence, predictive factors and impact on mortality. Circ J. 2017;81(5):660–7.CrossRefPubMed

Salamo O, Roghaee S, Schweitzer MD, Mantero A, Shafazand S, Campos M, et al. White donor, younger donor and double lung transplant are associated with better survival in sarcoidosis patients. Sci Rep. 2018;8(1):6968.CrossRefPubMedPubMedCentral

Schuba B, Scheklinski M, von Dossow V, Schneider C, Preissler G, Kneidinger N, et al. Five-year experience using the lung allocation score: the munich lung transplant group. Eur J CardioThorac Surg. 2018;54(2):328–33.CrossRefPubMed

Van Raemdonck D, Keshavjee S, Levvey B, Cherikh WS, Snell G, Erasmus M, et al. Donation after circulatory death in lung transplantation-five-year follow-up from ISHLT Registry. J Heart Lung Transplant. 2019;38(12):1235–45.CrossRefPubMed

Blitzer D, Copeland H, Roe D, Hage C, Wang IW, Duncan M, et al. Long term survival after lung transplantation: A single center experience. J Card Surg. 2020;35(2):273–8.CrossRefPubMed

10.

AworiHayanga JW, Aboagye JK, Shigemura N, Hayanga HK, Murphy E, Khaghani A, et al. Airway complications after lung transplantation: Contemporary survival and outcomes. J Heart Lung Transplant. 2016;35(10):1206–11.CrossRef

11.

Paradela M, González D, Parente I, Fernández R, De La Torre MM, Delgado M, et al. Surgical risk factors associated with lung transplantation. Transpl Proc. 2009;41(6):2218–20.CrossRef

12.

Shadmehr MB, Arab M, Pejhan S, Daneshvar A, Javaherzadeh N, Abbasi A, et al. Eight years of lung transplantation: experience of the National Research Institute of Tuberculosis and Lung Diseases. Transpl Proc. 2009;41(7):2887–9.CrossRef

13.

Oto T, Griffiths AP, Levvey BJ, Pilcher DV, Williams TJ, Snell GI. Definitions of primary graft dysfunction after lung transplantation: differences between bilateral and single lung transplantation. J Thorac Cardiovasc Surg. 2006;132(1):140–7.CrossRefPubMed

14.

Wang Q, Rogers CA, Bonser RS, Banner NR, Demiris N, Sharples LD. Assessing the benefit of accepting a single lung offer now compared with waiting for a subsequent double lung offer. Transplantation. 2011;91(8):921–6.CrossRefPubMed

15.

Anderson MR, Tabah A, RoyChoudhury A, Lederer DJ. Procedure preference and intention-to-treat outcomes after listing for lung transplantation among U.S. adults. A cohort study. Ann Am Thorac Soc. 2019;16(2):231–9.CrossRefPubMedPubMedCentral

16.

de Perrot M, Chaparro C, McRae K, Waddell TK, Hadjiliadis D, Singer LG, et al. Twenty-year experience of lung transplantation at a single center: Influence of recipient diagnosis on long-term survival. J Thorac Cardiovasc Surg. 2004;127(5):1493–501.CrossRefPubMed

17.

Latos M, Nęcki M, Pawlak D, Urlik M, Antończyk R, Ochman M, et al. Outcome of lung transplantation as a treatment of patients with chronic obstructive pulmonary disease: a single-center study. Transplant Proc. 2020;52(7):2118–22.CrossRefPubMed

18.

Munson JC, Christie JD, Halpern SD. The societal impact of single versus bilateral lung transplantation for chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2011;184(11):1282–8.CrossRefPubMedPubMedCentral

19.

Cai J. Double- and single-lung transplantation: an analysis of twenty years of OPTN/UNOS registry data. Clin Transpl. 2007:1–8.

20.

Meyer DM, Bennett LE, Novick RJ, Hosenpud JD. Single vs bilateral, sequential lung transplantation for end-stage emphysema: influence of recipient age on survival and secondary end-points. J Heart Lung Transplant. 2001;20(9):935–41.CrossRefPubMed

21.

Cassivi SD, Meyers BF, Battafarano RJ, Guthrie TJ, Trulock EP, Lynch JP, et al. Thirteen-year experience in lung transplantation for emphysema. Ann Thorac Surg. 2002;74(5):1663–9; discussion 9-70.CrossRefPubMed

22.

Burton CM, Milman N, Carlsen J, Arendrup H, Eliasen K, Andersen CB, et al. The Copenhagen National Lung Transplant Group: survival after single lung, double lung, and heart-lung transplantation. J Heart Lung Transplant. 2005;24(11):1834–43.CrossRefPubMed

23.

Güneş A, Aboyoun CL, Morton JM, Plit M, Malouf MA, Glanville AR. Lung transplantation for chronic obstructive pulmonary disease at St Vincent’s Hospital. Intern Med J. 2006;36(1):5–11.CrossRefPubMed

24.

Hadjiliadis D, Chaparro C, Gutierrez C, Steele MP, Singer LG, Davis RD, et al. Impact of lung transplant operation on bronchiolitis obliterans syndrome in patients with chronic obstructive pulmonary disease. Am J Transplant. 2006;6(1):183–9.CrossRefPubMed

25.

Stavem K, Bjørtuft Ø, Borgan Ø, Geiran O, Boe J. Lung transplantation in patients with chronic obstructive pulmonary disease in a national cohort is without obvious survival benefit. J Heart Lung Transplant. 2006;25(1):75–84.CrossRefPubMed

26.

Nwakanma LU, Simpkins CE, Williams JA, Chang DC, Borja MC, Conte JV, et al. Impact of bilateral versus single lung transplantation on survival in recipients 60 years of age and older: analysis of United Network for Organ Sharing database. J Thorac Cardiovasc Surg. 2007;133(2):541–7.CrossRefPubMed

27.

Thabut G, Ravaud P, Christie JD, Castier Y, Fournier M, Mal H, et al. Determinants of the survival benefit of lung transplantation in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2008;177(10):1156–63.CrossRefPubMed

28.

Delgado M, Borro JM, De La Torre MM, Fernández R, González D, Paradela M, et al. Lung transplantation as the first choice in emphysema. Transpl Proc. 2009;41(6):2207–9.CrossRef

29.

Bennett DT, Zamora M, Reece TB, Mitchell JD, Cleveland JC Jr, Grover FL, et al. Continued utility of single-lung transplantation in select populations: chronic obstructive pulmonary disease. Ann Thorac Surg. 2015;100(2):437–42.CrossRefPubMed

30.

Schaffer JM, Singh SK, Reitz BA, Zamanian RT, Mallidi HR. Single- vs double-lung transplantation in patients with chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis since the implementation of lung allocation based on medical need. JAMA. 2015;313(9):936–48.CrossRefPubMed

31.

Gulack BC, Mulvihill MS, Ganapathi AM, Speicher PJ, Chery G, Snyder LD, et al. Survival after lung transplantation in recipients with alpha-1-antitrypsin deficiency compared to other forms of chronic obstructive pulmonary disease: a national cohort study. Transpl Int. 2018;31(1):45–55.CrossRefPubMed

32.

Crawford TC, Lui C, Magruder JT, Ha JS, Higgins RS, Merlo CA, et al. Five-year mortality hazard is reduced in chronic obstructive pulmonary disease patients receiving double- versus single-lung transplants. J Surg Res. 2019;237:118–25.CrossRefPubMed

33.

Siddiqui FM, Diamond JM. Lung transplantation for chronic obstructive pulmonary disease: past, present, and future directions. Curr Opin Pulm Med. 2018;24(2):199–204.CrossRefPubMedPubMedCentral

34.

Chambers DC, Yusen RD, Cherikh WS, Goldfarb SB, Kucheryavaya AY, Khusch K, et al. The Registry of the International Society for Heart and Lung Transplantation: thirty-fourth adult lung and heart-lung transplantation report-2017; focus theme: allograft ischemic time. J Heart Lung Transplant. 2017;36(10):1047–59.CrossRefPubMed

Title: Double lung transplantation is better than single lung transplantation for end-stage chronic obstructive pulmonary disease: a meta-analysis
Authors: Yu-Chi Fang
Wen-Hsin Cheng
Hung-I Lu
Yi-Shi Wang
Kai-Hao Chuang
Hsing-Hua Lai
Yu Chen
Li-Chun Chen
Meng-Yun Tsai
Yu-Ping Chang
Kuo-Tung Huang
Chien-Ming Lo
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Chronic Obstructive Lung Disease
Alpha-1 Antitrypsin Deficiency
Published in: Journal of Cardiothoracic Surgery / Issue 1/2024
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-024-02654-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Double lung transplantation is better than single lung transplantation for end-stage chronic obstructive pulmonary disease: a meta-analysis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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