Cano J R, Algar F J, Cerezo F, Moreno P, Espinosa D, Alvarez A, Baamonde C, Santos F, Salvatierra A
Thoracic Surgery and Lung Transplantation Service, Reina Sofia University Hospital, Department of Medico-Surgical Specialities, University of Cordoba, Cordoba, Spain.
Transplant Proc. 2008 Nov;40(9):3073-5. doi: 10.1016/j.transproceed.2008.09.004.
The objective of this study was to evaluate the results and survival rates of patients who underwent lung transplantation (LT) to treat chronic obstructive pulmonary disease (COPD).
We performed a retrospective analysis of 63 patients with COPD who underwent LT between 1996 and 2007. Our statistical analysis was based on descriptive statistics and survival analysis (Kaplan-Meier and log-rank test).
Sixty-three LTs were performed in 53 male and 10 female patients with COPD. Twenty-eight LTs were unipulmonary and 35 were bipulmonary. Four cases required extracorporeal circulation. Surgical complications arose in 18 cases. There were 3 cases of intraoperative death as a result of cardiac failure. The most frequent long-term complications were hypertension (39.7%), renal failure (42.9%), and neoplasms (20.6%). Overall survival times (mean, 2553 days) were 75.9%, 74.15%, 65.67%, 55.87%, and 42.05% at 1, 2, 3, 5, and 10 years, respectively. No differences were observed in survival according to the following: donor age >30 years (P = 8), type of transplantation (unilateral vs bilateral; P = .57), donor intubation time >48 hours (P = .2), or donor oxygenation index <450 mm Hg (P = .3).
No differences were observed in survival according to the type of transplantation (unilateral vs bilateral), which suggests that unipulmonary transplantation is a reasonable option, given that this procedure reduces both the ischemia time compared with bilateral transplantation and the surgery time, as well as offering more efficient use of donor organs.
