Post-transplant survival in idiopathic pulmonary fibrosis patients concurrently listed for single and double lung transplantation

• Published in: The Journal of heart and lung transplantation Vol. 35; no. 5; pp. 657 - 660
• Main Authors: Chauhan, Dhaval, Karanam, Ashwin B., Merlo, Aurelie, Tom Bozzay, PA, Zucker, Mark J., Seethamraju, Harish, Shariati, Nazly, Russo, Mark J.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2016
• Subjects: Graft Survival; Humans; Idiopathic Pulmonary Fibrosis; Lung; Lung Transplantation; Pulmonary Fibrosis; single vs. double lung transplant; Surgery; survival analysis; UNOS/OPTN; single vs. double lung transplant; lung transplantation; UNOS/OPTN; idiopathic pulmonary fibrosis; survival analysis
• ISSN: 1053-2498; 1557-3117; 1557-3117
• DOI: 10.1016/j.healun.2015.12.030

Lung transplantation is a widely accepted treatment for patients with end-stage lung disease related to idiopathic pulmonary fibrosis (IPF). However, there are conflicting data on whether double lung transplant (DLT) or single lung transplant (SLT) is the superior therapy in these patients. The purpose of this study was to determine whether actuarial post-transplant graft survival among IPF patients concurrently listed for DLT and SLT is greater for recipients undergoing the former or the latter. The United Network for Organ Sharing provided de-identified patient-level data. Analysis included lung transplant candidates with IPF listed between January 1, 2001 and December 31, 2009 (n = 3,411). The study population included 1,001 (29.3%) lung transplant recipients concurrently listed for DLT and SLT, all ≥18 years of age. The primary outcome measure was actuarial post-transplant graft survival, expressed in years. Among the study population, 433 (43.26%) recipients underwent SLT and 568 (56.74%) recipients underwent DLT. The analysis included 2,722.5 years at risk, with median graft survival of 5.31 years. On univariate (p = 0.317) and multivariate (p = 0.415) regression analyses, there was no difference in graft survival between DLT and SLT. Among IPF recipients concurrently listed for DLT and SLT, there is no statistical difference in actuarial graft survival between recipients undergoing DLT vs SLT. This analysis suggests that increased use of SLT for IPF patients may increase the availability of organs to other candidates, and thus increase the net benefit of these organs, without measurably compromising outcomes.