title: Combined lung and liver transplantation: the United States experience.
abstract: BACKGROUND
  Combined transplantation of the lungs and liver is indicated for patients who would not be expected to survive transplantation of either organ alone. No single center has accumulated a significant experience, and as a result the expectations for this operation in the current era are unknown.
  
  
  METHODS
  Patients that have undergone combined lung-liver transplantation in the United States were enrolled through the United Network for Organ Sharing Organ Procurement and Transplantation Network database. In addition, the English-language literature was searched for additional cases of combined lung-liver transplantation.
  
  
  RESULTS
  Eleven patients have undergone combined lung and liver transplantation in the United States at different centers. The 1- and 5-year patient survival rates are of 79% and 63%, respectively, and no patient has required retransplantation. These patient survival rates are equivalent to similar a combined lung-liver case series from the United Kingdom (P=0.37, log-rank test) and isolated orthotopic liver transplantation in the United States (P=0.59, log-rank test), and are comparable to patient survival rates following isolated lung transplantation in the United States.
  
  
  CONCLUSIONS
  Patient survival of combined lung-liver transplantation is comparable to that of isolated liver and isolated bilateral lung transplantation. This option should be considered for patients with end-stage lung disease and liver disease when transplantation of a single organ transplantation is precluded by severe disease in the other organ system.
authors.affiliation: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: Neal R
authors.initials: NR
authors.lastname: Barshes
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: DiBardino
authors.forename: E Dean
authors.initials: ED
authors.lastname: McKenzie
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Lee
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Stayer
authors.forename: George B
authors.initials: GB
authors.lastname: Mallory
authors.forename: Saul J
authors.initials: SJ
authors.lastname: Karpen
authors.forename: Ruben E
authors.initials: RE
authors.lastname: Quiros-Tejeira
authors.forename: Beth A
authors.initials: BA
authors.lastname: Carter
authors.forename: Charles D
authors.initials: CD
authors.lastname: Fraser
authors.forename: John A
authors.initials: JA
authors.lastname: Goss
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D016208:Databases, Factual; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000706:statistics & numerical data; D016040:Lung Transplantation / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D009927:Tissue and Organ Procurement; D014481:United States