Outcomes After Lung Retransplantation: A Single-Center Retrospective Cohort Study

Abstract

LUNG retransplantation (LRT) is a treatment option for severe graft dysfunction. Although the survival rates for patients who underwent LRT between 1996 and 2005 were discouraging, recent data show that when LRT is offered in the appropriate clinical context and performed in experienced centers, outcomes may approach those of primary lung transplant (PLT). 1 Magee JC Barr ML Basadonna GP et al. Repeat organ transplantation in the United States, 1996-2005. Am J Transplant. 2007; 7: 1424-1433 Google Scholar , 2 Aigner C Jaksch P Taghavi S et al. Pulmonary retransplantation: Is it worth the effort? A long-term analysis of 46 cases. J Heart Lung Transplant. 2008; 27: 60-65 Google Scholar , 3 Biswas Roy S Panchanathan R Walia R et al. Lung retransplantation for chronic rejection: A single-center experience. Ann Thorac Surg. 2018; 105: 221-227 Google Scholar , 4 Osho AA Castleberry AW Snyder LD et al. Differential outcomes with early and late repeat transplantation in the era of the lung allocation score. Ann Thorac Surg. 2014; 98 (discussion 1920-1): 1914-1920 Google Scholar Although LRT accounts for nearly 2.5% of all lung transplants, this proportion is increasing as the long-term survival after PLT continues to improve. 5 Thomas M Belli EV Rawal B et al. Survival after lung retransplantation in the United States in the current era (2004 to 2013): Better or worse?. Ann Thorac Surg. 2015; 100: 452-457 Google Scholar Moreover, since its introduction in 2005, the lung allocation score (LAS) has favored LRT candidates, as demonstrated by their shorter times on the wait list and higher LAS compared to PLT candidates. 3 Biswas Roy S Panchanathan R Walia R et al. Lung retransplantation for chronic rejection: A single-center experience. Ann Thorac Surg. 2018; 105: 221-227 Google Scholar ,6 Kawut SM Lederer DJ Keshavjee S et al. Outcomes after lung retransplantation in the modern era. Am J Respir Crit Care Med. 2008; 177: 114-120 Google Scholar The aim of this study was to estimate graft survival for patients who underwent LRT at the authors’ institution over a ten-year period. The authors also evaluated associations of pre-LRT recipient and donor characteristics with graft survival after LRT.