Indications for and outcomes after combined lung and liver transplantation: a single-center experience on 13 consecutive cases

• Published in: Transplantation Vol. 85; no. 4; p. 524
• Main Authors: Grannas, Gerrit, Neipp, Michael, Hoeper, Marius M, Gottlieb, Jens, Lück, Rainer, Becker, Thomas, Simon, Andre, Strassburg, Christian P, Manns, Michael P, Welte, Tobias, Haverich, Axel, Klempnauer, Jürgen, Nashan, Björn, Strueber, Martin
• Format: Journal Article
• Language: English
• Published: United States 27.02.2008
• Subjects: Adult; Female; Graft Rejection - epidemiology; Graft Survival; Heart-Lung Transplantation - methods; Heart-Lung Transplantation - mortality; Humans; Hypertension, Pulmonary - complications; Hypertension, Pulmonary - surgery; Infection - epidemiology; Liver Diseases - complications; Liver Diseases - surgery; Liver Transplantation - methods; Liver Transplantation - mortality; Lung Transplantation - methods; Lung Transplantation - mortality; Male; Middle Aged; Postoperative Complications - classification; Postoperative Complications - epidemiology; Retrospective Studies; Survival Analysis
• ISSN: 0041-1337; 1534-6080
• DOI: 10.1097/TP.0b013e3181636f3f

Combined lung and liver transplantation (Lu-LTx) is a therapeutic option for selected patients with coexisting lung and liver disease. For several reasons, Lu-LTx is performed in few centers and information about the technical issues, posttransplant management and long-term outcomes associated with this procedure is limited. We analyzed data from 13 consecutive patients who underwent combined Lu-LTx at Hannover Medical School (Hannover, Germany) between April 1999 and December 2003. The main indications were cystic fibrosis, alpha1-proteinase inhibitor deficiency and portopulmonary hypertension. All patients had advanced cirrhosis and severe pulmonary disease manifestation. Ten patients received a sequential double Lu-LTx, one patient received a single Lu-LTx, one received a double lung and split liver transplantation, and one received an en-bloc heart-lung and liver transplantation. Immunosuppression was based on cyclosporine in a triple/quadruple regimen. Postoperative surgical complications occurred in eight patients. There were two perioperative deaths; two patients died during the first year on day 67 and 354, respectively, and one patient died at month 53. The overall patient survival rates at 1, 3, and 5 years were 69%, 62%, and 49%, respectively. Combined Lu-LTx is a therapeutic option for highly selected patients with end-stage lung and liver disease with acceptable long-term outcome.