Outcomes after Lung Retransplantation in the Modern Era

Abstract

Retransplant cohort (n 5 184) (hazard ratio, 0.7; 95% confidence interval, 0.5-0.9; P 5 0.006). However, modern retransplant recip- ients had a higher risk of death than that of patients who underwent initial lung transplantation (n 5 5,657) (hazard ratio, 1.3; 95% confidence interval, 1.2-1.5; P 5 0.001), which appeared to be explained by a higher prevalence of certain comorbidities. Retrans- plantation at less than 30 days after the initial transplant procedure was associated with worse survival. Conclusions: Outcomes after lung retransplantation have improved; however, retransplantation continues to pose an increased risk of death compared with the initial transplant procedure. Retransplantation early after the initial transplant poses a particularly high mortality risk. Lung transplantation is a therapeutic option for patients with advanced lung disease. Despite surgical and medical innovations, the outcomes after lung transplantation lag behind those of other solid organ recipients. Primary graft dysfunction and technical problems may lead to death early after transplantation, whereas acute and chronic rejection (manifest by bronchiolitis obliterans syndrome (BOS)) may contribute to later demise. There are no established medical therapies for many of these complications. Lung retransplantation may be used to treat these conditions if