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Journal of Transplantation
Volume 2011, Article ID 535649, 4 pages
http://dx.doi.org/10.1155/2011/535649
Clinical Study

Single-Lung Transplantation in the Setting of Aborted Bilateral Lung Transplantation

1Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA
2Division of Cardiothoracic Surgery, Barnes Jewish Hospital, One Barnes Jewish Hospital Plaza, 3108 Queeny Tower, St. Louis, MO 63110, USA

Received 17 December 2010; Revised 28 February 2011; Accepted 11 April 2011

Academic Editor: J. V. Conte

Copyright © 2011 Varun Puri et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The outcome of patients undergoing a single-lung transplant in the setting of an aborted bilateral lung transplant is unclear. Methods. A retrospective review of single lung transplants at an institutional program. Results. Of the 543 lung transplants performed over the last 10 years, 31 (5.7%) were single-lung transplants. Nineteen of 31 (61%) were planned single-lung transplants, while 12/31 (39%) were intraoperatively aborted, double lung transplants converted to single-lung transplants. The aborted and planned groups were similar in age, lung allocation score and NYHA status. The reasons for aborted double lung transplantation were cardiac/hemodynamic instability 4/12 (33%), difficult pneumonectomy 3/12 (25%), size mismatch 4/12(33%), and technical issues 1/12 (8%). The aborted group had higher CPB utilization (5/12 versus 1/19, 𝑃 = . 0 2 ), similar ischemic times (260 versus 234 min) and similar incidence of grade 3 primary graft dysfunction (6/12 versus 3/19, 𝑃 = . 1 3 ). ECMO was required for graft dysfunction in 2 patients in the aborted group. The one and two-year survival was 84% and 79% in the planned group and 62% and 52% in the aborted group, respectively. Conclusions. Patients undergoing single-lung transplantation in the setting of an aborted bilateral lung transplant may be at a higher risk of worse outcomes.