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Lung retransplantation: a new era for lung transplantation

Budev, Marie M

Current Opinion in Organ Transplantation: October 2007 - Volume 12 - Issue 5 - p 464–468
doi: 10.1097/MOT.0b013e3282f00503
Lung transplantation: Edited by David P. Mason
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Purpose of review Lung-graft loss is one potential problem for the majority of lung-transplant recipients. Should this loss occur, retransplantation might be a treatment option, despite controversial issues due to early experiences that reported poor survival outcomes. The purpose of this paper is to review recent international registries and single-center experiences in lung retransplantation as well as ethical issues that face the transplant community.

Recent findings Aggregate experiences from the United Organ Sharing Network Registry Analysis and single-center reports describe common trends and factors that may impact early and late outcomes in retransplantation. Recent retransplantation data identify survival outcomes equivalent to first-time transplants. Best survival outcomes for repeat transplantation are ambulatory patients diagnosed with bronchiolitis obliterans syndrome. Retransplanation in ventilator-dependent or primary graft dysfunction patients have a much poorer prognosis.

Summary Although accumulated registries and transplant center data support the argument for lung retransplantation, the evidence indicates that repeat lung transplantation is most successful in stable patients with bronchiolitis obliterans syndrome. In addition, the number of medical and ethical challenges faced by the transplant community regarding retransplantation requires further investigation.

Department of Pulmonary and Critical Care Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA

Correspondence to Marie M. Budev, DO, MPH, FCCP, Cleveland Clinic Foundation, Department of Pulmonary and Critical Care Medicine, 9500 Euclid Avenue, Cleveland, OH 44195, USA Tel: +1 216 444 3194; fax: +1 216 445 8160; e-mail: budevm@ccf.org

© 2007 Lippincott Williams & Wilkins, Inc.