Lung retransplantation for bronchiolitis obliterans syndrome after primary lung transplantation

Abstract

Objective To investigate the outcome of lung retransplantation for recipients with bronchiolitis obliterans syndrome (BOS) after primary lung transplantation. Methods Lung retransplantations were performed for 7 recipients with BOS after primary transplantation in Wuxi People′s Hospital. The primary diseases were diagnosed with end-stage pulmonary diseases, in which there were 2 interstitial pneumonia, 1 bronchiectasis, 1 pulmonary hypertension, 1 BOS following hematopoietic cell transplantation and 2 chronic obstructive pulmonary disease. These recipients with gradual decline in pulmonary function after first lung transplant received lung retransplantations for BOS. Two recipients received bilateral sequence lung transplantation and one of which was under extracorporeal membrane oxygenation support. Five recipients received single lung transplantation and one of which was under extracorporeal membrane oxygenation support. Results The course of operations were smooth. Case 1 died of infection on postoperative day 8 and case 2 died of multiple organ failure resulting from post-resuscitation syndrome on the fourth day after operation. The remaining 5 recipients recoved well during the follow-up until July 2017 and the pulmonary function was improved significantly. Conclusion Lung retransplantation is an important therapeutic strategy in treating BOS following initial transplant and more important issues like selection criteria of recipient, surgical method and risk factors for postoperation survival still need further research. Key words: Lung retransplantation; Bronchiolitis obliterans syndrome; Pulmonary function