Thirty years of lung transplantation: development of postoperative outcome and survival over three decades
Lung transplantation (LuTX) can be the last resort for patients with end-stage lung diseases. In the last decades, improvements were implemented in transplant medicine, from immunosuppression throughout preservation of the donor organ to enhance lung allograft survival. This retrospective study aims...
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| Veröffentlicht in: | Journal of thoracic disease 2024-12, Vol.16 (12), p.8513-8527 |
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| creator | Vorstandlechner, Maximilian Schneider, Christian P Fertmann, Jan M Michel, Sebastian Kneidinger, Nikolaus Walter, Julia Irlbeck, Michael Hatz, Rudolf A Behr, Jürgen Zwissler, Bernhard Hagl, Christian Meiser, Bruno Kauke, Teresa |
| description | Lung transplantation (LuTX) can be the last resort for patients with end-stage lung diseases. In the last decades, improvements were implemented in transplant medicine, from immunosuppression throughout preservation of the donor organ to enhance lung allograft survival. This retrospective study aims to illustrate the development of the LuTX-program at the University Hospital of Munich, LMU, Munich, Germany, since its launch in 1990 by depicting and comparing postoperative outcome.
We analyzed all LuTX performed from 1990 to 2019. Data was collected on indication for transplantation (TX), date, type (double/single) and postoperative survival. Survival analysis and Kaplan-Meier estimator were used to identify factors that are detrimental to post-LuTX-outcome.
A total of 1,054 LuTX were performed over 30 years, comprising overall 1,024 patients (30 retransplantations). The best results regarding five-year survival rates (5-YSR) were observed in patients with lymphangioleiomyomatosis (LAM) and hypersensitivity pneumonitis (HP) (5-YSR: LAM: 78.6%, HP: 73.6%). We could show that besides that the type of LuTX played a crucial role in post-TX survival, depicting double superior to single LuTX (5-YSR: single: 47.2%, double: 64.5%). Additionally, cytomegalovirus (CMV) risk constellation (high/intermediate risk; P=0.02) and infection (P |
| doi_str_mv | 10.21037/jtd-24-326 |
| format | Article |
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We analyzed all LuTX performed from 1990 to 2019. Data was collected on indication for transplantation (TX), date, type (double/single) and postoperative survival. Survival analysis and Kaplan-Meier estimator were used to identify factors that are detrimental to post-LuTX-outcome.
A total of 1,054 LuTX were performed over 30 years, comprising overall 1,024 patients (30 retransplantations). The best results regarding five-year survival rates (5-YSR) were observed in patients with lymphangioleiomyomatosis (LAM) and hypersensitivity pneumonitis (HP) (5-YSR: LAM: 78.6%, HP: 73.6%). We could show that besides that the type of LuTX played a crucial role in post-TX survival, depicting double superior to single LuTX (5-YSR: single: 47.2%, double: 64.5%). Additionally, cytomegalovirus (CMV) risk constellation (high/intermediate risk; P=0.02) and infection (P<0.001) were identified as risk factors for deteriorated survival.
Data analysis demonstrates that the field of LuTX has undergone enormous progress over the years. Therapeutic advances and improvements in interdisciplinary cooperation, pre- and postoperative management, changes in immunosuppressive medication, diagnosis and treatment of allograft rejections have clearly improved lung allograft and patient survival.</description><identifier>ISSN: 2072-1439</identifier><identifier>EISSN: 2077-6624</identifier><identifier>DOI: 10.21037/jtd-24-326</identifier><identifier>PMID: 39831218</identifier><language>eng</language><publisher>China: AME Publishing Company</publisher><subject>Original</subject><ispartof>Journal of thoracic disease, 2024-12, Vol.16 (12), p.8513-8527</ispartof><rights>2024 AME Publishing Company. All rights reserved.</rights><rights>2024 AME Publishing Company. All rights reserved. 2024 AME Publishing Company.</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0002-0824-9359</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740024/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740024/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39831218$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vorstandlechner, Maximilian</creatorcontrib><creatorcontrib>Schneider, Christian P</creatorcontrib><creatorcontrib>Fertmann, Jan M</creatorcontrib><creatorcontrib>Michel, Sebastian</creatorcontrib><creatorcontrib>Kneidinger, Nikolaus</creatorcontrib><creatorcontrib>Walter, Julia</creatorcontrib><creatorcontrib>Irlbeck, Michael</creatorcontrib><creatorcontrib>Hatz, Rudolf A</creatorcontrib><creatorcontrib>Behr, Jürgen</creatorcontrib><creatorcontrib>Zwissler, Bernhard</creatorcontrib><creatorcontrib>Hagl, Christian</creatorcontrib><creatorcontrib>Meiser, Bruno</creatorcontrib><creatorcontrib>Kauke, Teresa</creatorcontrib><title>Thirty years of lung transplantation: development of postoperative outcome and survival over three decades</title><title>Journal of thoracic disease</title><addtitle>J Thorac Dis</addtitle><description>Lung transplantation (LuTX) can be the last resort for patients with end-stage lung diseases. In the last decades, improvements were implemented in transplant medicine, from immunosuppression throughout preservation of the donor organ to enhance lung allograft survival. This retrospective study aims to illustrate the development of the LuTX-program at the University Hospital of Munich, LMU, Munich, Germany, since its launch in 1990 by depicting and comparing postoperative outcome.
We analyzed all LuTX performed from 1990 to 2019. Data was collected on indication for transplantation (TX), date, type (double/single) and postoperative survival. Survival analysis and Kaplan-Meier estimator were used to identify factors that are detrimental to post-LuTX-outcome.
A total of 1,054 LuTX were performed over 30 years, comprising overall 1,024 patients (30 retransplantations). The best results regarding five-year survival rates (5-YSR) were observed in patients with lymphangioleiomyomatosis (LAM) and hypersensitivity pneumonitis (HP) (5-YSR: LAM: 78.6%, HP: 73.6%). We could show that besides that the type of LuTX played a crucial role in post-TX survival, depicting double superior to single LuTX (5-YSR: single: 47.2%, double: 64.5%). Additionally, cytomegalovirus (CMV) risk constellation (high/intermediate risk; P=0.02) and infection (P<0.001) were identified as risk factors for deteriorated survival.
Data analysis demonstrates that the field of LuTX has undergone enormous progress over the years. Therapeutic advances and improvements in interdisciplinary cooperation, pre- and postoperative management, changes in immunosuppressive medication, diagnosis and treatment of allograft rejections have clearly improved lung allograft and patient survival.</description><subject>Original</subject><issn>2072-1439</issn><issn>2077-6624</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNpVkd1LwzAUxYMoOqZPvkseBanmq03mi8jwCwa-7D3E9HbraJuapIX992abit6XXDi_nBxyELqk5JZRwuXdJpYZExlnxRGaMCJlVhRMHO93llHBZ2foIoQNSVMQxqQ8RWd8pjhlVE3QZrmufdziLRgfsKtwM3QrHL3pQt-YLppYu-4elzBC4_oWuriDehei68EndQTshmhdC9h0JQ6DH-vRNNiN4HFce4B02ZoSwjk6qUwT4OL7nKLl89Ny_pot3l_e5o-LzFKVF9kuJBGlqfiMMmWFIUbls1KJgnJirJXGUq6sZMKSCsRHpSjwQiiolKSJmaKHg20_fLRQ2hTZm0b3vm6N32pnav1f6eq1XrlRUyoFIUwkh-tvB-8-BwhRt3Ww0KT_ADcEzWku85xKxRN6c0CtdyF4qH7foUTvC9KpIM2ETgUl-upvtF_2pw7-BW-5jlU</recordid><startdate>20241231</startdate><enddate>20241231</enddate><creator>Vorstandlechner, Maximilian</creator><creator>Schneider, Christian P</creator><creator>Fertmann, Jan M</creator><creator>Michel, Sebastian</creator><creator>Kneidinger, Nikolaus</creator><creator>Walter, Julia</creator><creator>Irlbeck, Michael</creator><creator>Hatz, Rudolf A</creator><creator>Behr, Jürgen</creator><creator>Zwissler, Bernhard</creator><creator>Hagl, Christian</creator><creator>Meiser, Bruno</creator><creator>Kauke, Teresa</creator><general>AME Publishing Company</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0824-9359</orcidid></search><sort><creationdate>20241231</creationdate><title>Thirty years of lung transplantation: development of postoperative outcome and survival over three decades</title><author>Vorstandlechner, Maximilian ; Schneider, Christian P ; Fertmann, Jan M ; Michel, Sebastian ; Kneidinger, Nikolaus ; Walter, Julia ; Irlbeck, Michael ; Hatz, Rudolf A ; Behr, Jürgen ; Zwissler, Bernhard ; Hagl, Christian ; Meiser, Bruno ; Kauke, Teresa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1856-602204daf39128c4a0a859d846130acc7ac138c724c0fe4bf81e3648ef871613</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Original</topic><toplevel>online_resources</toplevel><creatorcontrib>Vorstandlechner, Maximilian</creatorcontrib><creatorcontrib>Schneider, Christian P</creatorcontrib><creatorcontrib>Fertmann, Jan M</creatorcontrib><creatorcontrib>Michel, Sebastian</creatorcontrib><creatorcontrib>Kneidinger, Nikolaus</creatorcontrib><creatorcontrib>Walter, Julia</creatorcontrib><creatorcontrib>Irlbeck, Michael</creatorcontrib><creatorcontrib>Hatz, Rudolf A</creatorcontrib><creatorcontrib>Behr, Jürgen</creatorcontrib><creatorcontrib>Zwissler, Bernhard</creatorcontrib><creatorcontrib>Hagl, Christian</creatorcontrib><creatorcontrib>Meiser, Bruno</creatorcontrib><creatorcontrib>Kauke, Teresa</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of thoracic disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vorstandlechner, Maximilian</au><au>Schneider, Christian P</au><au>Fertmann, Jan M</au><au>Michel, Sebastian</au><au>Kneidinger, Nikolaus</au><au>Walter, Julia</au><au>Irlbeck, Michael</au><au>Hatz, Rudolf A</au><au>Behr, Jürgen</au><au>Zwissler, Bernhard</au><au>Hagl, Christian</au><au>Meiser, Bruno</au><au>Kauke, Teresa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Thirty years of lung transplantation: development of postoperative outcome and survival over three decades</atitle><jtitle>Journal of thoracic disease</jtitle><addtitle>J Thorac Dis</addtitle><date>2024-12-31</date><risdate>2024</risdate><volume>16</volume><issue>12</issue><spage>8513</spage><epage>8527</epage><pages>8513-8527</pages><issn>2072-1439</issn><eissn>2077-6624</eissn><abstract>Lung transplantation (LuTX) can be the last resort for patients with end-stage lung diseases. In the last decades, improvements were implemented in transplant medicine, from immunosuppression throughout preservation of the donor organ to enhance lung allograft survival. This retrospective study aims to illustrate the development of the LuTX-program at the University Hospital of Munich, LMU, Munich, Germany, since its launch in 1990 by depicting and comparing postoperative outcome.
We analyzed all LuTX performed from 1990 to 2019. Data was collected on indication for transplantation (TX), date, type (double/single) and postoperative survival. Survival analysis and Kaplan-Meier estimator were used to identify factors that are detrimental to post-LuTX-outcome.
A total of 1,054 LuTX were performed over 30 years, comprising overall 1,024 patients (30 retransplantations). The best results regarding five-year survival rates (5-YSR) were observed in patients with lymphangioleiomyomatosis (LAM) and hypersensitivity pneumonitis (HP) (5-YSR: LAM: 78.6%, HP: 73.6%). We could show that besides that the type of LuTX played a crucial role in post-TX survival, depicting double superior to single LuTX (5-YSR: single: 47.2%, double: 64.5%). Additionally, cytomegalovirus (CMV) risk constellation (high/intermediate risk; P=0.02) and infection (P<0.001) were identified as risk factors for deteriorated survival.
Data analysis demonstrates that the field of LuTX has undergone enormous progress over the years. Therapeutic advances and improvements in interdisciplinary cooperation, pre- and postoperative management, changes in immunosuppressive medication, diagnosis and treatment of allograft rejections have clearly improved lung allograft and patient survival.</abstract><cop>China</cop><pub>AME Publishing Company</pub><pmid>39831218</pmid><doi>10.21037/jtd-24-326</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0002-0824-9359</orcidid><oa>free_for_read</oa></addata></record> |
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| title | Thirty years of lung transplantation: development of postoperative outcome and survival over three decades |
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