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Bilateral Lung Transplantation Offers Better Long-Term Survival, Compared With Single-Lung Transplantation, for Younger Patients With Idiopathic Pulmonary Fibrosis
Open accessAbstract
Background Single-lung transplantation (SLT) and bilateral lung transplantation (BLT) are both good options for patients with end-stage lung disease secondary to idiopathic pulmonary fibrosis. It is, however, unclear whether BLT offers any survival advantage over SLT. The purpose of our study was to evaluate a large group of patients to determine if either SLT or BLT officered a long-term survival advantage for patients with IPF.Methods This was an Institutional Review Board-approved retrospective analysis of the United Network of Organ Sharing database from 1987 to 2008. Survival was determined using Kaplan-Meir estimates and the effect of laterality was determined by Cox proportional hazards and propensity analyses.Results Lung transplantation for idiopathic pulmonary fibrosis was performed in 3,860 patients (2,431 SLTs and 1429 BLTs). Multivariate and propensity analysis failed to show any survival advantage for BLT (hazard ratio = 0.90, 95% confidence interval = 0.78 to 1.0, p = 0.11). One-year conditional survival favored BLT (hazard ratio 0.73, 95% confidence interval 0.60 to 0.87, p = 0.00064). Risk factors for early death included recipient age over 57 and donor age over 36 years.Conclusions Bilateral lung transplantation should be considered for younger patients with idiopathic pulmonary fibrosis and results may be optimized when younger donors are used.
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Among 3,830 IPF patients in an OPTN analysis who received transplants between 1997 and 2008, patients who received BLT had significantly longer mean survival (8.34 years) compared to SLT (7.37 years), with HR for mortality 0.798 (95% CI 0.716 to 0.889).
“Among 3,830 IPF patients included in an analysis of the OPTN data who received transplants between 1997 and 2008, patients who received a BLT had significantly (P < 0.001) longer mean survival (8.34 years) compared to patients who received a SLT (7.37 years), (HR for mortality: 0.798 [95% CI 0.716 to 0.889]) [51].”
From Lung transplantation in idiopathic pulmonary fibrosis: a systematic review of the literature (2014) · cites this paper as [51]
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Experimental — accuracy not yet measuredAt five years post-transplantation, approximately 60% of BLT and 53% of SLT recipients were alive; at ten years, approximately 48% and 30% were alive.
“At five years’ post-transplantation, approximately 60% and 53% of patients who received BLT and SLT transplants, respectively, were alive [51]. At ten years’ post-transplantation, approximately 48% and 30% of patients who received BLT and SLT transplants, respectively, were alive [51].”
From Lung transplantation in idiopathic pulmonary fibrosis: a systematic review of the literature (2014) · cites this paper as [51]
The Results (page unavailable) report an unadjusted long-term survival advantage for BLT over SLT, consistent with the direction of the cited comparison. They do not give the claimed five-year or ten-year survival percentages; searches for those rates found no matching passage in our copy. (LLM, conf=0.78)
Experimental — accuracy not yet measuredLong-term survival conditional on surviving one year was significantly better for patients who received BLT vs. SLT (12.08 years vs. 6.8 years).
“Long-term survival, conditional to surviving one-year, was also significantly (P < 0.0006) better for patients who received a BLT vs. SLT (12.08 years versus 6.8 years) [51].”
From Lung transplantation in idiopathic pulmonary fibrosis: a systematic review of the literature (2014) · cites this paper as [51]
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Metadata
- Authors
- Force, S. D., Kilgo, P., Neujahr, D. C., Pelaez, A., Pickens, A., Fernandez, F. G., Miller, D. L., & Lawrence, C.
- Affiliations
- Emory University (US)
- Corresponding author
- Force, Seth D.
- Venue
- The Annals of Thoracic Surgery
- Publisher
- Elsevier BV
- Published
- 2011-01
- Volume
- 91
- Issue
- 1
- Pages
- 244-249
- ISSN
- 0003-4975 (ISSN-L)
- PMC
- PMC3395073
- OpenAlex
- W2162066400
- Cited by
- 69
- References
- 18
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 4 · 2022: 5 · 2021: 3 · 2020: 4 · 2019: 9 · 2018: 11 · 2017: 5 · 2016: 7 · 2015: 6 · 2014: 5 · 2013: 2 · 2012: 2
- FWCI
- 2.37
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Annals of Thoracic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Allergy and Infectious Diseases (K08AI079166)
- Topics
- Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Organ Donation and Transplantation
- Keywords
- bilateral lung transplantation, single lung transplantation, idiopathic pulmonary fibrosis, long-term survival, donor age, recipient age, end-stage lung disease, transplant outcomes
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Female, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Cohort Studies, Survival Rate, Survival Analysis, Lung Transplantation, Treatment Outcome, Idiopathic Pulmonary Fibrosis, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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