Combined lung and liver transplantation: the United States experience.
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.
Barshes
Neal R
NR
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
DiBardino
Daniel J
DJ
McKenzie
E Dean
ED
Lee
Timothy C
TC
Stayer
Stephen A
SA
Mallory
George B
GB
Karpen
Saul J
SJ
Quiros-Tejeira
Ruben E
RE
Carter
Beth A
BA
Fraser
Charles D
CD
Goss
John A
JA
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