Pulmonary retransplantation: is it worth the effort? A long-term analysis of 46 cases

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
C AignerW Klepetko

Abstract

Pulmonary retransplantation remains the only therapeutic option in some cases of severe primary graft dysfunction (PGD), advanced bronchiolitis obliterans syndrome (BOS), and in some cases of severe airway problems (AWP), mainly cicatriceal stenosis. However, its value has been questioned due to the overall scarcity of donor organs and reports indicating unsatisfactory outcome. We analyzed our institutional experience with pulmonary retransplantation to evaluate its value for different indications. We retrospectively analyzed all 46 patients undergoing pulmonary retransplantation from the 567 consecutive primary lung or heart-lung transplantations performed in our department from August 1995 to August 2006. We stratified patients according to indication for retransplantation and analyzed the outcome. Forty-six patients (mean age 41 +/- 16 years, 18 men and 28 women) underwent pulmonary retransplantation (14 bilateral lung transplantations, 32 single-lung transplantations) for primary graft dysfunction (n = 23), bronchiolitis obliterans syndrome (n = 19) and airway problems (n = 4). Mean time to retransplantation was 26 +/- 27 days in the PGD group, 1,069 +/- 757 days in the BOS group and 220 +/- 321 days in the AWP group. Thirt...Continue Reading

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