|
|
||||||||
J Thorac Cardiovasc Surg 2004;127:1493-1501
© 2004 The American Association for Thoracic Surgery
Cardiothoracic transplantation |
a Toronto Lung Transplant Program, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
Read at the Eighty-third Annual Meeting of The American Association for Thoracic Surgery, Boston, Mass, May 4-7, 2003.
Received for publication May 2, 2003; revisions received October 29, 2003; accepted for publication November 1, 2003.
* Address for reprints: S. Keshavjee, MD, Director, Toronto Lung Transplant Program, Toronto General Hospital, 200 Elizabeth St, EN 10-224, Toronto, M5G 2C4 Ontario, Canada
shaf.keshavjee{at}uhn.on.ca
OBJECTIVES: The objective of this study was to examine the long-term patient outcomes of lung transplantation in a single center.
METHODS: Between 1983 and 2003, 521 lung transplants were performed in 501 patients. Major indications were cystic fibrosis (n = 124), chronic obstructive pulmonary disease (n = 88), alpha-1 antitrypsin deficiency (n = 63), pulmonary fibrosis (n = 97), primary pulmonary hypertension (n = 35), Eisenmenger syndrome (n = 21), and miscellaneous end-stage lung diseases (n = 93).
RESULTS: The 5-, 10-, and 15-year survivals for all recipients were 55.1% (95% confidence interval: ±5%), 35.3% (±6%), and 26.5% (±11%), respectively. The most common causes of death were sepsis and bronchiolitis obliterans syndrome. Despite an increased postoperative mortality rate, patients with primary pulmonary hypertension achieved the best long-term survival (10-year survival: 59%). Recipients with cystic fibrosis without Burkholderia cepacia infection achieved significantly better long-term survival (10-year survival: 52%) than those with Burkholderia cepacia infection (10-year survival: 15%). The 10-year survival was also significantly better in recipients with chronic obstructive pulmonary disease (43%) than in recipients with alpha-1 antitrypsin deficiency (23%). Although the incidence of bronchiolitis obliterans syndrome was similar between recipients with chronic obstructive pulmonary disease (39%) and alpha-1 antitrypsin deficiency (46%), recipients with alpha-1 antitrypsin deficiency died of sepsis more frequently than recipients with chronic obstructive pulmonary disease (27% vs 6%, respectively; P = .0003).
CONCLUSIONS: Although bronchiolitis obliterans syndrome and sepsis still limit the durability of the benefit, lung transplantation returns many patients with end-stage lung disease to active and productive lives. Differences in the complications and long-term survival show the important contribution of the recipient diagnosis to the success of lung transplantation.
This article has been cited by other articles:
![]() |
G Meachery, A De Soyza, A Nicholson, G Parry, A Hasan, K Tocewicz, T Pillay, S Clark, J L Lordan, S Schueler, et al. Outcomes of lung transplantation for cystic fibrosis in a large UK cohort Thorax, August 1, 2008; 63(8): 725 - 731. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. De Soyza, A. Silipo, R. Lanzetta, J. R. Govan, and A. Molinaro Review: Chemical and biological features of Burkholderia cepacia complex lipopolysaccharides Innate Immunity, June 1, 2008; 14(3): 127 - 144. [Abstract] [PDF] |
||||
![]() |
J. L. Bobadilla, R. B. Love, E. Jankowska-Gan, Q. Xu, L. D. Haynes, R. K. Braun, M. S. Hayney, A. Munoz del Rio, K. Meyer, D. S. Greenspan, et al. Th-17, Monokines, Collagen Type V, and Primary Graft Dysfunction in Lung Transplantation Am. J. Respir. Crit. Care Med., March 15, 2008; 177(6): 660 - 668. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. V. Venkateswaran, V. B. Patchell, I. C. Wilson, J. G. Mascaro, R. D. Thompson, D. W. Quinn, R. A. Stockley, J. H. Coote, and R. S. Bonser Early Donor Management Increases the Retrieval Rate of Lungs for Transplantation Ann. Thorac. Surg., January 1, 2008; 85(1): 278 - 286. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. S. Krishnam, R. D. Suh, A. Tomasian, J. G. Goldin, C. Lai, K. Brown, P. Batra, and D. R. Aberle Postoperative Complications of Lung Transplantation: Radiologic Findings along a Time Continuum RadioGraphics, July 1, 2007; 27(4): 957 - 974. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. De Perrot, T. K. Waddell, Y. Shargall, A. F. Pierre, E. Fadel, K. Uy, C. Chaparro, M. Hutcheon, L. G. Singer, and S. Keshavjee Impact of donors aged 60 years or more on outcome after lung transplantation: Results of an 11-year single-center experience J. Thorac. Cardiovasc. Surg., February 1, 2007; 133(2): 525 - 531. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. C. Chang, K. M. Chan, R. J. Lonigro, C. L. Lau, V. N. Lama, K. R. Flaherty, R. Florn, A. Pickens, S. Murray, F. J. Martinez, et al. Surgical patient outcomes after the increased use of bilateral lung transplantation J. Thorac. Cardiovasc. Surg., February 1, 2007; 133(2): 532 - 540. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. L. Taylor and S. M. Palmer Critical Care Perspective on Immunotherapy in Lung Transplantation J Intensive Care Med, December 1, 2006; 21(6): 327 - 344. [Abstract] [PDF] |
||||
![]() |
S. B. Johnson, A. M. Allred, A. M. Cline, L. F. Angel, E. Y. Sako, C. E. Baisden, and J. H. Calhoon Cardiac Procedures in Lung Transplant Recipients Do Not Increase Mortality in Selected Patients Ann. Thorac. Surg., August 1, 2006; 82(2): 460 - 464. [Abstract] [Full Text] [PDF] |
||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |