1. Concomitant abdominal organ transplantation alongside lung transplantation: An ISHLT transplant database analysis
- Author
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Renita Wilson, BS, J. Asher Jenkins, MD, Juan Maria Farina, MD, Blake Langlais, MS, Bashar Aqel, MD, Ashraf Omar, MD, Jonathan D’Cunha, MD, PhD, and Pedro Reck dos Santos, MD, PhD
- Subjects
concomitant transplant ,lung transplant ,abdominal transplant ,graft survival ,simultaneous transplant ,Surgery ,RD1-811 ,Specialties of internal medicine ,RC581-951 - Abstract
Background: Concomitant abdominal organ transplant of the liver, kidney, and/or pancreas with lung transplant (Con-AbLTx) may be considered for appropriate patients who present with end-stage disease of multiple organ systems. Most existing literature examines outcomes of combined lung-liver transplants, with little attention paid to other commonly transplanted abdominal organs, such as kidneys and pancreas. This study aims to examine post-transplant outcomes of patients submitted to Con-AbLTx to lung transplant (LTx)-only recipients. Methods: The international society for heart and lung transplantation (ISHLT) International Thoracic Organ Transplant Registry for Con-AbLTx and LTx-only was reviewed from January 1994 to June 2018. LTx-only recipients were propensity score matched 4:1 based on various patient characteristics. Data were analyzed with Fisher’s exact, Wilcoxon rank sum tests, Kaplan-Meier methods, and Cox proportional hazards where appropriate. Results: A total of 195 Con-AbLTx and 780 propensity-matched LTx-only cases were compared. LTx-only recipients demonstrated higher levels of bronchiolitis obliterans syndrome. Following transplant, Con-AbLTx required a longer hospital stay and post-transplant dialysis before discharge. LTx-only were more likely to experience graft failure from acute rejection or chronic rejection. Con-AbLTx experienced higher 1-year mortality than LTx-only counterparts, with the highest mortality seen in the concomitant lung/kidney group. Of concomitant transplants, lung/liver recipients had greater survival over time. Conclusions: Con-AbLTx has the potential to carry substantial morbidity. At 10 years post-transplant, there is no statistically significant difference in survival between LTx-only and Con-AbLTx recipients. Given limited organ availability and ethical considerations of simultaneous transplant, careful consideration for Con-AbLTx is paramount to achieve acceptable outcomes.
- Published
- 2025
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