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Cited by 14Transplantation: Methods and OutcomesOrgan Transplantation Techniques and OutcomesOrgan Donation and Transplantation

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Pulmonary Retransplantation

Novick, Richard J., Stitt, Larry·1998·Seminars in Thoracic and Cardiovascular Surgery
DOI 10.1016/s1043-0679(98)70041-3
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Abstract

Background and methods Despite improving results in lung transplantation, a significant number of grafts fail early or late postoperatively. The Pulmonary Retransplant Registry was founded in 1991 to determine the predictors of outcome after retransplantation, so as to facilitate decisions concerning the appropriateness of lung retransplantation in individual patients. In this study, 230 patients underwent retransplantation in 47 centers from 1985 to 1996. Logistic regression methods were used to determine variables associated with, and predictive of, survival and lung function after retransplantation. Results Actuarial survival was 47%+/-3%, 40%+/-3% and 33%+/-4% at 1, 2, and 3 years, respectively. On multivariable analysis, the predictors of survival included ambulatory status or lack of ventilator support preoperatively (P=.005, odds ratio 1.62, 95% confidence interval 1.15-2.27), followed by retransplantation after 1991 (P=.048, odds ratio 1.41, 95% confidence interval 1.003-1.99). Ambulatory, nonventilated patients undergoing retransplantation after 1991 had a 1-year survival rate of 64%+/-5% versus 33%+/-4% for nonambulatory, ventilated recipients. Eighty-one percent, 70%, 62%, and 56% of survivors were free of bronchiolitis obliterans syndrome at 1, 2, 3, and 4 years after retransplantation, respectively. Factors associated with freedom from stage 3 (severe) bronchiolitis obliterans syndrome at 2 years after retransplantation included an interval between transplants greater than 2 years (P=.01), the lack of ventilatory support before retransplantation (P=.03), increasing retransplant experience within each center (5th and higher retransplant patient, P=.04) and total center volume of 5 or more retransplant operations (P=.05). Conclusions Nonambulatory, ventilated patients should not be considered for retransplantation with the same priority as other candidates. The best intermediate-term functional results occurred in more experienced centers, in nonventilated patients and in patients undergoing retransplantation more than 2 years after their first transplantation. In view of the scarcity of lung donors, patient selection for retransplantation should remain strict.

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Crossref · 10.1016/s1043-0679(98)70041-3

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  • ReTx is associated with significantly lower survival than primary lung transplant, with 1-year survival ranging between 47% and 76%, and 5-year survival ranging between 21% and 55%.

    “Existing literature shows that ReTx is associated with significantly lower survival than primary lung transplant with 1-year survival ranging between 47% and 76%, and 5-year survival ranging between 21% and 55%.3, 4, 5, 6”

    From Lung retransplantation during the Lung Allocation Score era: Outcomes from a large single center (2026) · cites this paper as [4]

  • Younger age, lower acute graft dysfunction, and longer interval between primary and ReTx have all been previously linked to ReTx survival differences.

    “These factors had all been previously linked to ReTx survival differences.3, 4, 5, 6, 7, 8, 10, 11, 12, 13”

    From Lung retransplantation during the Lung Allocation Score era: Outcomes from a large single center (2026) · cites this paper as [4]

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Research works printed but not linked: 21

  1. Hosenpud, 1996, The registry of the International Society for Heart and Lung Transplantation: 13th official report - 1996, J Heart Lung Transplant, 15, 655
  2. Cooper, 1994, Results of single and bilateral lung transplantation in 131 consecutive recipients, J Thorac Cardiovasc Surg, 107, 460, 10.1016/S0022-5223(94)70091-5 · DOI
  3. Novick, 1996, Lung preservation: the importance of endothelial and alveolar type lI cell integrity, Ann Thorac Surg, 62, 302, 10.1016/0003-4975(96)00333-5 · DOI
  4. Date, 1995, Improved airway healing after lung transplantation: An analysis of 348 bronchial anastomoses, J Thorac Cardiovasc Surg, 110, 1424, 10.1016/S0022-5223(95)70065-X · DOI
  5. Sundaresan, 1995, Prevalence and outcome of bronchiolitis obliterans syndrome after lung transplantation, Ann Thorac Surg, 60, 1341, 10.1016/0003-4975(95)00751-6 · DOI
  6. Reichenspurner, 1995, Obliterative bronchiolitis after lung and heart-lung transplantation, Ann Thorac Surg, 60, 1845, 10.1016/0003-4975(95)00776-8 · DOI
  7. Fournier, 1993, Single-lung retransplantation for late graft failure, Eur Respir J, 6, 1202, 10.1183/09031936.93.06081202 · DOI
  8. Adams, 1994, Retransplantation in heart-lung recipients with obliterative bronchiolitis, J Thorac Cardiovasc Surg, 107, 450, 10.1016/S0022-5223(94)70090-7 · DOI
  9. Schafers, 1995, Retransplantation of the lung: a single center experience, Eur J Cardiothorac Surg, 9, 291, 10.1016/S1010-7940(05)80184-8 · DOI
  10. Novick, 1993, Redo lung transplantation: A North American-European experience, J Heart Lung Transplant, 12, 5
  11. Novick, 1994, Pulmonary retransplantation for obliterative bronchiolitis: Intermediate-term results of a North American-European series, J Thorac Cardiovasc Surg, 107, 755, 10.1016/S0022-5223(94)70331-0 · DOI
  12. Novick, 1995, Seventy-two pulmonary re transplantations for obliterative bronchiolitis: Predictors of survival, Ann Thorac Surg, 60, 111, 10.1016/S0003-4975(95)00369-X · DOI
  13. Novick, 1995, Recurrence of obliterative bronchiolitis and determinants of outcome in 139 pulmonary retransplant recipients, J Thorac Cardiovasc Surg, 110, 1402, 10.1016/S0022-5223(95)70063-3 · DOI
  14. Novick, 1996, Pulmonary retransplantation: Does the indication for operation influence postoperative lung function?, J Thorac Cardiovasc Surg, 112, 1504, 10.1016/S0022-5223(96)70009-0 · DOI
  15. Cooper, 1993, A working formulation for the standardization of nomenclature and for clinical staging of chronic dysfunction in lung allografts, J Heart Lung Transplant, 12, 713
  16. Egan, 1995, Improved results of lung transplantation for patients with cystic fibrosis, J Thorac Cardiovasc Surg, 109, 224, 10.1016/S0022-5223(95)70383-7 · DOI
  17. Collins, 1993, Cardiac re transplantation: Determining limits, Heart Lung, 22, 206
  18. Ubel, 1993, Rationing failure: The ethical lessons of the retransplantation of scarce vital organs, JAMA, 270, 2469, 10.1001/jama.1993.03510200075035 · DOI
  19. Mentzer, 1994, Ethical considerations in lung retransplantation, J Heart Lung Transplant, 13, 56
  20. Huston, 1996, Health services research: Reporting on studies using secondary data sources, Can Med Assoc J, 155, 1697
  21. Thorogood, 1991, Prognostic indices to predict survival of first and second renal allografts, Transplantation, 52, 831, 10.1097/00007890-199111000-00015 · DOI

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Metadata

Authors
Novick, R. J., & Stitt, L.
Affiliations
Western University (CA)
Corresponding author
Novick, Richard J.
ORCID
Novick, Richard J.
Venue
Seminars in Thoracic and Cardiovascular Surgery
Publisher
Elsevier BV
Published
1998-07
Volume
10
Issue
3
Pages
227-236
ISSN
1043-0679 (ISSN-L)
DOI
10.1016/s1043-0679(98)70041-3
OpenAlex
W4249139583
Cited by
14
References
0
Citations by year
2026: 1 · 2020: 2 · 2016: 1
FWCI
1.17
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Seminars in Thoracic and Cardiovascular Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
  • Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Organ Donation and Transplantation
Keywords
lung retransplantation, lung transplantation, graft failure, survival predictors, bronchiolitis obliterans syndrome, ambulatory status, ventilator dependence, center volume, transplant candidate selection, mid-term outcomes, long-term outcomes, risk stratification
MeSH terms
Actuarial Analysis, Adolescent, Adult, Australia, Bronchiolitis Obliterans, Canada, Child, Child, Preschool, Europe, Female, Humans, Infant, Male, Reoperation, Respiratory Function Tests, United States, Multivariate Analysis, Logistic Models, Survival Analysis, Lung Transplantation

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