Native lung surgery after single lung transplantation: clinical characteristics and outcomes

• Published in: Surgery today (Tokyo, Japan) Japan), 2024-10, Vol.54 (10), p.1131-1137
• Main Authors: Nagata, Hideki, Kanou, Takashi, Fukui, Eriko, Kimura, Toru, Ose, Naoko, Funaki, Soichiro, Shintani, Yasushi
• Format: Article
• Language: English
• Subjects: Adult; Aged; Female; Humans; Lung - surgery; Lung Diseases - surgery; Lung Diseases, Interstitial - surgery; Lung Neoplasms - surgery; Lung Transplantation - methods; Lymphangioleiomyomatosis - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Pneumonectomy - methods; Pneumothorax - etiology; Pneumothorax - surgery; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Pulmonary Aspergillosis - surgery; Pulmonary Disease, Chronic Obstructive - surgery; Surgery; Surgical Oncology; Survival Rate; Treatment Outcome
• ISSN: 0941-1291; 1436-2813; 1436-2813
• DOI: 10.1007/s00595-024-02828-8

Purpose Single lung transplantation (SLT) is a viable option for patients with end-stage pulmonary parenchymal and vascular diseases. However, various diseases can occur in native lungs after SLT. Methods Between January 2000 and December 2021, 35 patients underwent cadaveric SLT and survived for more than 30 days in our hospital. Among these 35 patients, 10 required surgery for diseases that developed in their native lungs. The clinical characteristics of these 10 patients and the outcomes of native lung surgery (NLS) were investigated. Results Among these ten patients, the indications for lung transplantation were chronic obstructive pulmonary disease and idiopathic interstitial pneumonia in three patients each, and lymphangioleiomyomatosis and collagen vascular disease-related interstitial pneumoniain two patients each. The causes of NLS included pneumothorax ( n  = 4), primary lung cancer ( n  = 2), native lung hyperinflation ( n  = 2), and pulmonary aspergilloma ( n  = 2). The surgical procedures were pneumonectomy ( n  = 7), lobectomy ( n  = 2), and alveolar-pleural fistula repair ( n  = 1). Only one postoperative complication, empyema, was treated with antibiotics. The 5-year overall survival rates after transplantation with and without NLS were 70.0% and 80.0%, respectively, and did not differ to a statistically extent ( p  = 0.56). Conclusion NLS is an effective treatment option for diseases that develop in the native lungs after SLT.