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Lung transplantation in chronic obstructive pulmonary disease: long‐term survival, freedom from bronchiolitis obliterans syndrome, and factors influencing outcome
Author(s) -
Zeriouh Mohamed,
Mohite Prashant N.,
Sabashnikov Anton,
Zych Bartlomiej,
Patil Nikhil P.,
GarciaSaez Diana,
Koch Achim,
Ghodsizad Ali,
Weymann Alexander,
Soresi Simona,
Wittwer Thorsten,
Choi YeongHoon,
Wippermann Jens,
Wahlers Thorsten,
Popov AronFrederik,
Simon André R.
Publication year - 2015
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12528
Subject(s) - medicine , bronchiolitis obliterans , copd , lung transplantation , retrospective cohort study , pulmonary function testing , transplantation , cumulative incidence , surgery , cohort , lung
Objectives Lung transplantation ( LT x) remains the definitive treatment for end‐stage lung failure, whereas chronic obstructive pulmonary disease ( COPD ) represents one of the main diagnoses leading to the indication for a transplant. We sought to assess long‐term outcomes after LT x in patients diagnosed with COPD and analyze factors influencing outcome in this frequent patient cohort. Methods Between January 2007 and November 2013, a total of 88 LT x were performed in patients with COPD in our institution. Patients with emphysema associated with alpha1‐antitrypsin deficiency were excluded from this observation. The study design was a retrospective review of the prospectively collected data. A large number of pre‐, intra‐, and postoperative variables were analyzed including long‐term survival and freedom from bronchiolitis obliterans syndrome ( BOS ). Furthermore, impact of different variables on survival was analyzed. Results Preoperative donor data indicated a large proportion of marginal donors. While the overall cumulative survival after six yr was 57.4%, the results in terms of BOS ‐free survival in long‐term follow‐up were 39.7% after six yr. Patients with COPD were also associated with a low incidence (2.3%) of the need for postoperative extracorporeal life support ( ECLS ). Conclusions Long‐term results after LT x in patients with COPD are acceptable with excellent survival, freedom from BOS , and low use of ECLS postoperatively despite permanently increasing proportion of marginal organs used.