Redo lung transplantation for acute and chronic lung allograft failure: long-term follow-up in a single center.
OBJECTIVE
This study was undertaken to evaluate outcomes of redo lung transplantation (LT) for acute and chronic graft failure.


METHODS
Between 1988 and 2007, 388 LT procedures were performed on 369 patients. From those, 17 (4.6%) patients had redo LT once and 2 patients had redo LT twice. Patient survival and recurrence of bronchiolitis obliterans syndrome (BOS) after redo LT were reviewed.


RESULTS
The overall survival rates of the 17 redo LT recipients at 1, 2 and 5 years were 59+/-23%, 59+/-23% and 42+/-25%, respectively. For the chronic graft failure group (n=12), survival rates at 1, 2 and 5 years were 67+/-26%, 67+/-26% and 44+/-30%, respectively. These survival rates were significantly lower than the survival rates observed in our experience after primary LT (n=352, 1-, 2- and 5-year survival rates of 88+/-4%, 80+/-4% and 65+/-5%, respectively. For the acute graft failure group (n=5), the 1-year survival rate was 40%; two patients remain free from BOS. Two patients had a second redo LT, one died from multi-organ failure on postoperative day 86 and the other died from pulmonary aspergillosis on postoperative day 214.


CONCLUSIONS
Redo LT is a valid therapeutic option for selected patients with BOS and might be an option for highly selected patients with acute lung graft failure. Outcomes from a second redo LT are poor, and a second lung retransplantation must be used very cautiously, if at all.
Osaki
Satoru
S
Division of Cardiothoracic Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Hospital and Clinics, Madison, WI 53792-3236, USA.
Maloney
James D
JD
Meyer
Keith C
KC
Cornwell
Richard D
RD
Edwards
Niloo M
NM
De Oliveira
Nilto C
NC
D000328:Adult; D001989:Bronchiolitis Obliterans / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000401:mortality / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016040:Lung Transplantation / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D055732:Pulmonary Aspergillosis / Q000401:mortality; D012008:Recurrence; D012086:Reoperation / Q000401:mortality; D015996:Survival Rate; D014184:Transplantation, Homologous