The following is the summary of “Clinical features and outcomes of unplanned single lung transplants” published in the December 2022 issue of Thoracic and cardiovascular surgery by Terada, et al.

Whether a single lung transplant or a double lung transplant will be performed is often decided upon in advance of surgery. Researchers have previously observed that there may be an increased risk of worse short-term outcomes for patients who unexpectedly get single lung transplants in the context of an aborted double lung transplant. The long-term success rate of single-lung transplants performed on an emergency basis is unknown. From 2000 to 2020, researchers looked at data from a central repository on lung transplants. After analyzing surgical notes, single lung transplants were divided into two categories: those that were planned and those that were not. 

Unexpected single-lung transplants were the subject of a root-cause study. About 1,265 (95%) of the 1,326 lung transplants were bilateral, whereas 61 (5%) were unilateral, with 22 being planned and 39 being unplanned. Chronic obstructive pulmonary disease (55%) and idiopathic pulmonary fibrosis (45%) accounted for the majority of planned single lung transplants, while COPD (23%), IPF (39%), and bronchiolitis obliterans syndrome (13%) accounted for the majority of unplanned transplants. Donor-related variables accounted for (3, 7.7%) of the unplanned lung transplants, whereas recipient-related factors accounted for 31 (80%), and both donor and recipient-related factors accounted for 5 (13%) of the transplants. Ischemic durations were lower in unscheduled procedures than in planned ones (planned: 251 58 minutes vs. unplanned: 221 48 minutes), although more unplanned single lung transplants required cardiopulmonary bypass (4/22, 18% vs. 20/39, 51%).

The 5-year overall survival was 53% in the planned and 58% in the unplanned groups, respectively (P=.323). There was no significant difference in the number of years people were able to live with no dysfunction after receiving a lung transplant in chronic illness (P=.995). Unplanned single lung transplants in the circumstances of aborted double lung transplants may be associated with acceptable long-term outcomes.

Source: sciencedirect.com/science/article/abs/pii/S0022522322003634