Impact of chronic lung allograft dysfunction, especially restrictive allograft syndrome, on the survival after living-donor lobar lung transplantation compared with cadaveric lung transplantation in adults

a single-center experience

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: The differences in chronic lung allograft dysfunction (CLAD) between living-donor lobar lung transplantation (LDLLT) and cadaveric lung transplantation (CLT) remain unclear. We conducted this study to compare the impact of CLAD on the outcomes after LDLLT vs. CLT. Methods: We conducted a retrospective review of the data of 97 recipients of bilateral lung transplantation, including 51 recipients of LDLLT and 46 recipients of CLT. Results: The CLAD-free survival and overall survival after LDLLT were similar to those after CLT. CLAD and restrictive allograft syndrome (RAS), but not bronchiolitis obliterans syndrome (BOS), developed significantly later after LDLLT than after CLT (p = 0.015 and p = 0.035). Consequently, patients with CLAD and RAS, but not those with BOS, after LDLLT had a significantly better overall survival than those after CLT (p = 0.037 and p = 0.0006). Furthermore, after the diagnosis of CLAD, the survival of patients with RAS after LDLLT tended to be better than that after CLT (p = 0.083). Conclusion: CLAD, especially RAS, appears to develop later after LDLLT than after CLT and seems to have a lower impact on the overall survival after LDLLT than that after CLT.

Original languageEnglish
Pages (from-to)686-693
Number of pages8
JournalSurgery today
Volume49
Issue number8
DOIs
Publication statusPublished - Aug 9 2019

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Lung Transplantation
Living Donors
Allografts
Lung
Survival
Bronchiolitis Obliterans

Keywords

  • Bronchiolitis obliterans syndrome
  • Chronic lung allograft dysfunction
  • Living-donor
  • Lung transplantation
  • Rejection
  • Restrictive allograft syndrome

ASJC Scopus subject areas

  • Surgery

Cite this

@article{0491f8eb636442899612fa4c5e27b010,
title = "Impact of chronic lung allograft dysfunction, especially restrictive allograft syndrome, on the survival after living-donor lobar lung transplantation compared with cadaveric lung transplantation in adults: a single-center experience",
abstract = "Purpose: The differences in chronic lung allograft dysfunction (CLAD) between living-donor lobar lung transplantation (LDLLT) and cadaveric lung transplantation (CLT) remain unclear. We conducted this study to compare the impact of CLAD on the outcomes after LDLLT vs. CLT. Methods: We conducted a retrospective review of the data of 97 recipients of bilateral lung transplantation, including 51 recipients of LDLLT and 46 recipients of CLT. Results: The CLAD-free survival and overall survival after LDLLT were similar to those after CLT. CLAD and restrictive allograft syndrome (RAS), but not bronchiolitis obliterans syndrome (BOS), developed significantly later after LDLLT than after CLT (p = 0.015 and p = 0.035). Consequently, patients with CLAD and RAS, but not those with BOS, after LDLLT had a significantly better overall survival than those after CLT (p = 0.037 and p = 0.0006). Furthermore, after the diagnosis of CLAD, the survival of patients with RAS after LDLLT tended to be better than that after CLT (p = 0.083). Conclusion: CLAD, especially RAS, appears to develop later after LDLLT than after CLT and seems to have a lower impact on the overall survival after LDLLT than that after CLT.",
keywords = "Bronchiolitis obliterans syndrome, Chronic lung allograft dysfunction, Living-donor, Lung transplantation, Rejection, Restrictive allograft syndrome",
author = "Seiichiro Sugimoto and Haruchika Yamamoto and Takeshi Kurosaki and Shinji Otani and Mikio Okazaki and Masaomi Yamane and Shinichi Toyooka and Takahiro Oto",
year = "2019",
month = "8",
day = "9",
doi = "10.1007/s00595-019-01782-0",
language = "English",
volume = "49",
pages = "686--693",
journal = "Japanese Journal of Surgery",
issn = "0941-1291",
publisher = "Springer Japan",
number = "8",

}

TY - JOUR

T1 - Impact of chronic lung allograft dysfunction, especially restrictive allograft syndrome, on the survival after living-donor lobar lung transplantation compared with cadaveric lung transplantation in adults

T2 - a single-center experience

AU - Sugimoto, Seiichiro

AU - Yamamoto, Haruchika

AU - Kurosaki, Takeshi

AU - Otani, Shinji

AU - Okazaki, Mikio

AU - Yamane, Masaomi

AU - Toyooka, Shinichi

AU - Oto, Takahiro

PY - 2019/8/9

Y1 - 2019/8/9

N2 - Purpose: The differences in chronic lung allograft dysfunction (CLAD) between living-donor lobar lung transplantation (LDLLT) and cadaveric lung transplantation (CLT) remain unclear. We conducted this study to compare the impact of CLAD on the outcomes after LDLLT vs. CLT. Methods: We conducted a retrospective review of the data of 97 recipients of bilateral lung transplantation, including 51 recipients of LDLLT and 46 recipients of CLT. Results: The CLAD-free survival and overall survival after LDLLT were similar to those after CLT. CLAD and restrictive allograft syndrome (RAS), but not bronchiolitis obliterans syndrome (BOS), developed significantly later after LDLLT than after CLT (p = 0.015 and p = 0.035). Consequently, patients with CLAD and RAS, but not those with BOS, after LDLLT had a significantly better overall survival than those after CLT (p = 0.037 and p = 0.0006). Furthermore, after the diagnosis of CLAD, the survival of patients with RAS after LDLLT tended to be better than that after CLT (p = 0.083). Conclusion: CLAD, especially RAS, appears to develop later after LDLLT than after CLT and seems to have a lower impact on the overall survival after LDLLT than that after CLT.

AB - Purpose: The differences in chronic lung allograft dysfunction (CLAD) between living-donor lobar lung transplantation (LDLLT) and cadaveric lung transplantation (CLT) remain unclear. We conducted this study to compare the impact of CLAD on the outcomes after LDLLT vs. CLT. Methods: We conducted a retrospective review of the data of 97 recipients of bilateral lung transplantation, including 51 recipients of LDLLT and 46 recipients of CLT. Results: The CLAD-free survival and overall survival after LDLLT were similar to those after CLT. CLAD and restrictive allograft syndrome (RAS), but not bronchiolitis obliterans syndrome (BOS), developed significantly later after LDLLT than after CLT (p = 0.015 and p = 0.035). Consequently, patients with CLAD and RAS, but not those with BOS, after LDLLT had a significantly better overall survival than those after CLT (p = 0.037 and p = 0.0006). Furthermore, after the diagnosis of CLAD, the survival of patients with RAS after LDLLT tended to be better than that after CLT (p = 0.083). Conclusion: CLAD, especially RAS, appears to develop later after LDLLT than after CLT and seems to have a lower impact on the overall survival after LDLLT than that after CLT.

KW - Bronchiolitis obliterans syndrome

KW - Chronic lung allograft dysfunction

KW - Living-donor

KW - Lung transplantation

KW - Rejection

KW - Restrictive allograft syndrome

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U2 - 10.1007/s00595-019-01782-0

DO - 10.1007/s00595-019-01782-0

M3 - Article

VL - 49

SP - 686

EP - 693

JO - Japanese Journal of Surgery

JF - Japanese Journal of Surgery

SN - 0941-1291

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ER -