1. Significantly reduced patient and graft survival for left vs right donor lungs for lung transplant recipients
- Author
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Sarah Y. Park, MD, Elizabeth Bashian, MD, Navin Vigneshwar, MD, Elizabeth A. David, MD, MAS, Simran K. Randhawa, MBBS, Robert A. Meguid, MD, MPH, John D. Mitchell, MD, Alice L. Gray, MD, Susana Arrigain, MA, Elizabeth A. Pomfret, MD, PhD, Jesse D. Schold, PhD, Michael T. Cain, MD, and Jordan R.H. Hoffman, MD, MPH
- Subjects
single lung transplant ,split lung transplantation ,mortality ,graft failure ,laterality ,Surgery ,RD1-811 ,Specialties of internal medicine ,RC581-951 - Abstract
Background: To evaluate the association of right vs left single lung transplants (SLT) from split lung donors with long-term post-transplant recipient outcomes. Methods: We performed a retrospective review of the Scientific Registry of Transplant Recipients data of split SLT adult recipients comparing right and left lung grafts between 2005 and 2021. We used a paired donor model to account for underlying differences between donors and evaluated post-transplant patient and graft survival with Cox proportional hazard models with robust variance estimates adjusted for recipient characteristics. We also used Wilcoxon signed-rank, McNemar’s, and Bowker’s tests to evaluate complication rates between donor pairs. Results: There were 5,180 recipients with 2,590 right and left split allografts. Left SLT had higher rates of mortality (hazards ratio [HR] = 1.17, 95% confidence interval [CI]: 1.08, 1.27) and graft failure (HR = 1.16, 95% CI: 1.06, 1.26) compared to right SLT in adjusted models. There were more early deaths (5 days) (n = 319, 12.6% vs n = 270, 10.6%; p = 0.030). Conclusions: Left SLT was associated with significantly worse mortality and graft failure while right SLT was associated with more short-term complications from split lung donors. Organ listing and acceptance decisions should consider donor lung laterality.
- Published
- 2024
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