Comprehensive outcomes after lung retransplantation: A single‐center review

Introduction Lung retransplantation is an important therapy for a growing population of lung transplant recipients with graft failure, but detailed outcome data are lacking. Methods We conducted a retrospective cohort study of adult lung retransplant in the Toronto Lung Transplant Program from 2001...

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Veröffentlicht in:Clinical transplantation 2018-06, Vol.32 (6), p.e13281-n/a
Hauptverfasser: Halloran, Kieran, Aversa, Meghan, Tinckam, Kathryn, Martinu, Tereza, Binnie, Matthew, Chaparro, Cecilia, Chow, Chung‐Wai, Waddell, Tom, McRae, Karen, Pierre, Andrew, Perrot, Marc, Yasufuku, Kazuhiro, Cypel, Marcelo, Keshavjee, Shaf, Singer, Lianne G.
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container_issue 6
container_start_page e13281
container_title Clinical transplantation
container_volume 32
creator Halloran, Kieran
Aversa, Meghan
Tinckam, Kathryn
Martinu, Tereza
Binnie, Matthew
Chaparro, Cecilia
Chow, Chung‐Wai
Waddell, Tom
McRae, Karen
Pierre, Andrew
Perrot, Marc
Yasufuku, Kazuhiro
Cypel, Marcelo
Keshavjee, Shaf
Singer, Lianne G.
description Introduction Lung retransplantation is an important therapy for a growing population of lung transplant recipients with graft failure, but detailed outcome data are lacking. Methods We conducted a retrospective cohort study of adult lung retransplant in the Toronto Lung Transplant Program from 2001 to 2013 (n = 38). We analyzed the postoperative course, graft function, renal function, microbiology, donor‐specific antibodies (DSA), quality of life, and survival compared to a control cohort of primary transplant recipients matched for age and era. Results Indication for retransplant was chronic lung allograft dysfunction in most retransplant recipients (35/38, 92%). The postoperative course was more complex after retransplant than primary (ventilation time, 8 vs 2 days, P 
doi_str_mv 10.1111/ctr.13281
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Methods We conducted a retrospective cohort study of adult lung retransplant in the Toronto Lung Transplant Program from 2001 to 2013 (n = 38). We analyzed the postoperative course, graft function, renal function, microbiology, donor‐specific antibodies (DSA), quality of life, and survival compared to a control cohort of primary transplant recipients matched for age and era. Results Indication for retransplant was chronic lung allograft dysfunction in most retransplant recipients (35/38, 92%). The postoperative course was more complex after retransplant than primary (ventilation time, 8 vs 2 days, P &lt; .01; ICU stay 14 vs 4 days, P &lt; 0.01), and peak lung function was lower (FEV1 2.2L vs 3L, P &lt; .01). Quality of life scores were comparable, as were renal function, microbiology, and donor‐specific antibody formation. Median survival was 1988 days after primary and 1475 days after retransplant (P = .39). Conclusions Lung retransplantation is associated with a more complex postoperative course and lower peak lung function, but the long‐term medical profile is similar to primary transplant. Lung retransplantation can be beneficial for carefully selected candidates with allograft failure.</description><identifier>ISSN: 0902-0063</identifier><identifier>EISSN: 1399-0012</identifier><identifier>DOI: 10.1111/ctr.13281</identifier><identifier>PMID: 29754418</identifier><language>eng</language><publisher>Denmark</publisher><subject>alloantibody ; chronic ; lung (allograft) function/dysfunction ; quality of life ; rejection ; retransplantation</subject><ispartof>Clinical transplantation, 2018-06, Vol.32 (6), p.e13281-n/a</ispartof><rights>2018 John Wiley &amp; Sons A/S. Published by John Wiley &amp; Sons Ltd</rights><rights>2018 John Wiley &amp; Sons A/S. Published by John Wiley &amp; Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3251-378a91d3c4674a95df9a7e9706aa45e201f165e8e58a795dc17314cb7f154eb03</citedby><cites>FETCH-LOGICAL-c3251-378a91d3c4674a95df9a7e9706aa45e201f165e8e58a795dc17314cb7f154eb03</cites><orcidid>0000-0002-2693-8676 ; 0000-0002-5615-6974</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fctr.13281$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fctr.13281$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29754418$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Halloran, Kieran</creatorcontrib><creatorcontrib>Aversa, Meghan</creatorcontrib><creatorcontrib>Tinckam, Kathryn</creatorcontrib><creatorcontrib>Martinu, Tereza</creatorcontrib><creatorcontrib>Binnie, Matthew</creatorcontrib><creatorcontrib>Chaparro, Cecilia</creatorcontrib><creatorcontrib>Chow, Chung‐Wai</creatorcontrib><creatorcontrib>Waddell, Tom</creatorcontrib><creatorcontrib>McRae, Karen</creatorcontrib><creatorcontrib>Pierre, Andrew</creatorcontrib><creatorcontrib>Perrot, Marc</creatorcontrib><creatorcontrib>Yasufuku, Kazuhiro</creatorcontrib><creatorcontrib>Cypel, Marcelo</creatorcontrib><creatorcontrib>Keshavjee, Shaf</creatorcontrib><creatorcontrib>Singer, Lianne G.</creatorcontrib><title>Comprehensive outcomes after lung retransplantation: A single‐center review</title><title>Clinical transplantation</title><addtitle>Clin Transplant</addtitle><description>Introduction Lung retransplantation is an important therapy for a growing population of lung transplant recipients with graft failure, but detailed outcome data are lacking. Methods We conducted a retrospective cohort study of adult lung retransplant in the Toronto Lung Transplant Program from 2001 to 2013 (n = 38). We analyzed the postoperative course, graft function, renal function, microbiology, donor‐specific antibodies (DSA), quality of life, and survival compared to a control cohort of primary transplant recipients matched for age and era. Results Indication for retransplant was chronic lung allograft dysfunction in most retransplant recipients (35/38, 92%). The postoperative course was more complex after retransplant than primary (ventilation time, 8 vs 2 days, P &lt; .01; ICU stay 14 vs 4 days, P &lt; 0.01), and peak lung function was lower (FEV1 2.2L vs 3L, P &lt; .01). Quality of life scores were comparable, as were renal function, microbiology, and donor‐specific antibody formation. Median survival was 1988 days after primary and 1475 days after retransplant (P = .39). Conclusions Lung retransplantation is associated with a more complex postoperative course and lower peak lung function, but the long‐term medical profile is similar to primary transplant. Lung retransplantation can be beneficial for carefully selected candidates with allograft failure.</description><subject>alloantibody</subject><subject>chronic</subject><subject>lung (allograft) function/dysfunction</subject><subject>quality of life</subject><subject>rejection</subject><subject>retransplantation</subject><issn>0902-0063</issn><issn>1399-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kEtOwzAQhi0EoqWw4AIoS1iktePYjtlVES-pCAmVteW6kxKUF3bSqjuOwBk5CS4p7JjNjGY-fRr9CJ0TPCa-Jqa1Y0KjhBygIaFShhiT6BANscSRnzkdoBPn3vyWE86O0SCSgsUxSYboMa3LxsIrVC5fQ1B3ralLcIHOWrBB0VWrwEJrdeWaQletbvO6ug6mgcurVQFfH58Gqh1pYZ3D5hQdZbpwcLbvI_RyezNP78PZ091DOp2FhkaMhFQkWpIlNTEXsZZsmUktQArMtY4ZRJhk_k9IgCVa-LMhgpLYLERGWAwLTEfosvc2tn7vwLWqzJ2Bwr8IdedUhGkiMOOcefSqR42tnbOQqcbmpbZbRbDapad8euonPc9e7LXdooTlH_kblwcmPbDJC9j-b1Lp_LlXfgODhnpI</recordid><startdate>201806</startdate><enddate>201806</enddate><creator>Halloran, Kieran</creator><creator>Aversa, Meghan</creator><creator>Tinckam, Kathryn</creator><creator>Martinu, Tereza</creator><creator>Binnie, Matthew</creator><creator>Chaparro, Cecilia</creator><creator>Chow, Chung‐Wai</creator><creator>Waddell, Tom</creator><creator>McRae, Karen</creator><creator>Pierre, Andrew</creator><creator>Perrot, Marc</creator><creator>Yasufuku, Kazuhiro</creator><creator>Cypel, Marcelo</creator><creator>Keshavjee, Shaf</creator><creator>Singer, Lianne G.</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2693-8676</orcidid><orcidid>https://orcid.org/0000-0002-5615-6974</orcidid></search><sort><creationdate>201806</creationdate><title>Comprehensive outcomes after lung retransplantation: A single‐center review</title><author>Halloran, Kieran ; Aversa, Meghan ; Tinckam, Kathryn ; Martinu, Tereza ; Binnie, Matthew ; Chaparro, Cecilia ; Chow, Chung‐Wai ; Waddell, Tom ; McRae, Karen ; Pierre, Andrew ; Perrot, Marc ; Yasufuku, Kazuhiro ; Cypel, Marcelo ; Keshavjee, Shaf ; Singer, Lianne G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3251-378a91d3c4674a95df9a7e9706aa45e201f165e8e58a795dc17314cb7f154eb03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>alloantibody</topic><topic>chronic</topic><topic>lung (allograft) function/dysfunction</topic><topic>quality of life</topic><topic>rejection</topic><topic>retransplantation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Halloran, Kieran</creatorcontrib><creatorcontrib>Aversa, Meghan</creatorcontrib><creatorcontrib>Tinckam, Kathryn</creatorcontrib><creatorcontrib>Martinu, Tereza</creatorcontrib><creatorcontrib>Binnie, Matthew</creatorcontrib><creatorcontrib>Chaparro, Cecilia</creatorcontrib><creatorcontrib>Chow, Chung‐Wai</creatorcontrib><creatorcontrib>Waddell, Tom</creatorcontrib><creatorcontrib>McRae, Karen</creatorcontrib><creatorcontrib>Pierre, Andrew</creatorcontrib><creatorcontrib>Perrot, Marc</creatorcontrib><creatorcontrib>Yasufuku, Kazuhiro</creatorcontrib><creatorcontrib>Cypel, Marcelo</creatorcontrib><creatorcontrib>Keshavjee, Shaf</creatorcontrib><creatorcontrib>Singer, Lianne G.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Halloran, Kieran</au><au>Aversa, Meghan</au><au>Tinckam, Kathryn</au><au>Martinu, Tereza</au><au>Binnie, Matthew</au><au>Chaparro, Cecilia</au><au>Chow, Chung‐Wai</au><au>Waddell, Tom</au><au>McRae, Karen</au><au>Pierre, Andrew</au><au>Perrot, Marc</au><au>Yasufuku, Kazuhiro</au><au>Cypel, Marcelo</au><au>Keshavjee, Shaf</au><au>Singer, Lianne G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comprehensive outcomes after lung retransplantation: A single‐center review</atitle><jtitle>Clinical transplantation</jtitle><addtitle>Clin Transplant</addtitle><date>2018-06</date><risdate>2018</risdate><volume>32</volume><issue>6</issue><spage>e13281</spage><epage>n/a</epage><pages>e13281-n/a</pages><issn>0902-0063</issn><eissn>1399-0012</eissn><abstract>Introduction Lung retransplantation is an important therapy for a growing population of lung transplant recipients with graft failure, but detailed outcome data are lacking. Methods We conducted a retrospective cohort study of adult lung retransplant in the Toronto Lung Transplant Program from 2001 to 2013 (n = 38). We analyzed the postoperative course, graft function, renal function, microbiology, donor‐specific antibodies (DSA), quality of life, and survival compared to a control cohort of primary transplant recipients matched for age and era. Results Indication for retransplant was chronic lung allograft dysfunction in most retransplant recipients (35/38, 92%). The postoperative course was more complex after retransplant than primary (ventilation time, 8 vs 2 days, P &lt; .01; ICU stay 14 vs 4 days, P &lt; 0.01), and peak lung function was lower (FEV1 2.2L vs 3L, P &lt; .01). Quality of life scores were comparable, as were renal function, microbiology, and donor‐specific antibody formation. Median survival was 1988 days after primary and 1475 days after retransplant (P = .39). Conclusions Lung retransplantation is associated with a more complex postoperative course and lower peak lung function, but the long‐term medical profile is similar to primary transplant. Lung retransplantation can be beneficial for carefully selected candidates with allograft failure.</abstract><cop>Denmark</cop><pmid>29754418</pmid><doi>10.1111/ctr.13281</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-2693-8676</orcidid><orcidid>https://orcid.org/0000-0002-5615-6974</orcidid></addata></record>
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subjects alloantibody
chronic
lung (allograft) function/dysfunction
quality of life
rejection
retransplantation
title Comprehensive outcomes after lung retransplantation: A single‐center review
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