title: Lung transplantation and concomitant cardiac surgery: Is it justified?
abstract: OBJECTIVE
  Increasing numbers of lung transplant candidates have cardiac conditions that affect their survival after transplantation. Our objective was to determine if patients who undergo concomitant cardiac surgery (CCS) during the lung transplant procedure have similar outcomes, as a cohort of isolated lung transplant recipients.
  
  
  METHODS
  This was a retrospective, observational, matched-cohort analysis. The records of lung transplant recipients who underwent CCS from August 2000 to August 2013 were reviewed. A cohort of isolated lung transplant recipients, matched on the basis of age, lung allocation score, diagnosis, type of procedure, and era, was identified. The primary endpoint of this trial was 5-year survival. The secondary endpoints were primary graft dysfunction, grade III, at 72 hours, intensive care unit and hospital length of stay, and 5-year major adverse cardiac event rates.
  
  
  RESULTS
  A total of 120 patients underwent lung transplantation and CCS. Compared with the isolated lung transplant group, the donor, recipient, and operation characteristics were similar. No difference was found in the survival of the 2 groups for up to 5 years, or in the incidence of primary graft dysfunction Grade III at 72 hours, intensive care unit length of stay, invasive ventilation, hospital length of stay, or incidence of 5-year major adverse cardiac events.
  
  
  CONCLUSIONS
  Lung transplant recipients undergoing CCS have early and midterm clinical outcomes similar to those of isolated lung transplant recipients. Given that this report is the largest published experience, offering cardiac surgery at the time of lung transplantation, to selected patients, remains justified.
authors.affiliation: Division of Cardiac Surgery, University of California, Los Angeles Medical Center, Los Angeles, Calif. Electronic address: rbiniwale@mednet.ucla.edu.
authors.forename: Reshma
authors.initials: R
authors.lastname: Biniwale
authors.affiliation: Division of Pulmonology, University of California, Los Angeles Medical Center, Los Angeles, Calif.
authors.forename: David
authors.initials: D
authors.lastname: Ross
authors.affiliation: Division of Cardiac Surgery, University of California, Los Angeles Medical Center, Los Angeles, Calif.
authors.forename: Amit
authors.initials: A
authors.lastname: Iyengar
authors.affiliation: Division of Cardiac Surgery, University of California, Los Angeles Medical Center, Los Angeles, Calif.
authors.forename: Oh Jin
authors.initials: OJ
authors.lastname: Kwon
authors.affiliation: Division of Cardiac Surgery, University of California, Los Angeles Medical Center, Los Angeles, Calif.
authors.forename: Curtis
authors.initials: C
authors.lastname: Hunter
authors.affiliation: Division of Adult Congenital Cardiology, University of California, Los Angeles, Los Angeles, Calif.
authors.forename: Jamil
authors.initials: J
authors.lastname: Aboulhosn
authors.affiliation: Pathology & Laboratory Medicine and Biostatistics, University of California, Los Angeles, Los Angeles, Calif.
authors.forename: David
authors.initials: D
authors.lastname: Gjertson
authors.affiliation: Division of Cardiac Surgery, University of California, Los Angeles Medical Center, Los Angeles, Calif.
authors.forename: Abbas
authors.initials: A
authors.lastname: Ardehali
mesh_terms: D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007362:Intensive Care Units; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008171:Lung Diseases / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016040:Lung Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D055031:Primary Graft Dysfunction / Q000175:diagnosis / Q000209:etiology; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
keywords: cardiac surgery; lung transplant; outcomes