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Cited by 22Transplantation: Methods and OutcomesChronic Obstructive Pulmonary Disease (COPD) ResearchNeonatal Respiratory Health Research

Previous lung volume reduction surgery does not negatively affect survival after lung transplantation†

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Inci, Ilhan, Iskender, Ilker, Ehrsam, Jonas, Caviezel, Claudio, Hillinger, Sven, Opitz, Isabelle, Schneiter, Didier, Weder, Walter·2018·European Journal of Cardio-Thoracic Surgery
DOI 10.1093/ejcts/ezx318
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Abstract

OBJECTIVES: Lung volume reduction surgery (LVRS) and lung transplantation (LTx) are the treatments of choice in selected patients with end-stage emphysema. Recently, the history of LVRS has been questioned due to reduced post-transplant survival. We aim to address this question by reviewing our experience, which is the largest single-centre series of LVRS followed by LTx. METHODS: We reviewed our prospectively recorded database in patients with emphysema undergoing LTx between 1993 and 2014. Preoperative workup and postoperative outcomes were compared according to previous LVRS status. The Kaplan-Meier test was used for survival analysis and compared with a log-rank test. RESULTS: One hundred and seventeen patients (66 men; mean age 56 ± 7 years) underwent LTx during the study period, 52 of whom had previous LVRS (LVRS + LTx). The mean time from LVRS to LTx was 45 ± 31 months. Patients were slightly older and had extensive smoking history in the LVRS + LTx group. Overall, in-hospital mortality was 10%, which did not differ significantly regardless of the history of LVRS (P = 0.8). The median survival for the LTx-only and LVRS + LTx groups was 86 [95% confidence interval (CI) 56-116] and 107 (95% CI 77-137) months, respectively (P = 0.6). CONCLUSIONS: Previous LVRS does not negatively affect short-term and long-term outcomes following LTx in patients with end-stage emphysema. The history of LVRS should not preclude the candidacy for LTx. Considering the limited number of donors available, the LVRS option should be kept in mind for the postponement of LTx in carefully selected patients.

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  • In patients who eventually need transplantation, pleural adhesions can be induced by LVR, which can lead to prolonged operation time and increased bleeding.

    “in patients who eventually need transplantation, pleural adhesions can be induced, which can lead to problems such as prolonged operation time and increased bleeding.”

    From Indications for Lung Transplantation and Patient Selection (2022) · cites this paper as [46]

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Authors
Inci, I., Iskender, I., Ehrsam, J., Caviezel, C., Hillinger, S., Opitz, I., Schneiter, D., & Weder, W.
Affiliations
  • Department of Thoracic Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland
  • University of Zurich (CH)
ORCID
Venue
European Journal of Cardio-Thoracic Surgery
Publisher
Oxford University Press (OUP)
Published
2017-09-08
Volume
53
Issue
3
Pages
596-602
ISSN
  • 1010-7940 (ISSN-L)
  • 1873-734X
DOI
10.1093/ejcts/ezx318
OpenAlex
W2753662159
Cited by
22
References
23
Citations by year
2026: 2 · 2025: 1 · 2024: 1 · 2023: 4 · 2022: 2 · 2021: 5 · 2020: 2 · 2019: 2 · 2018: 3
FWCI
1.97
Type
journal article
Language
en
Open access
Locations
  • European Journal of Cardio-Thoracic Surgery (publishedVersion)
  • PubMed (publishedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
Funders
Lunge Zürich
Topics
  • Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
Keywords
lung volume reduction surgery, lung transplantation, end-stage emphysema, post-transplant survival, in-hospital mortality, transplant eligibility, donor lung shortage, preoperative workup
MeSH terms
Emphysema, Female, Humans, Lung, Male, Middle Aged, Pneumonectomy, Retrospective Studies, Lung Transplantation, Kaplan-Meier Estimate

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