Concomitant abdominal organ transplantation alongside lung transplantation: An ISHLT transplant database analysis
Background: Concomitant abdominal organ transplant of the liver, kidney, and/or pancreas with lung transplant (Con-AbLTx) may be considered for appropriate patients who present with end-stage disease of multiple organ systems. Most existing literature examines outcomes of combined lung-liver transpl...
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Elsevier
2025-02-01
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| Series: | JHLT Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950133424001502 |
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| author | Renita Wilson, BS J. Asher Jenkins, MD Juan Maria Farina, MD Blake Langlais, MS Bashar Aqel, MD Ashraf Omar, MD Jonathan D’Cunha, MD, PhD Pedro Reck dos Santos, MD, PhD |
| author_facet | Renita Wilson, BS J. Asher Jenkins, MD Juan Maria Farina, MD Blake Langlais, MS Bashar Aqel, MD Ashraf Omar, MD Jonathan D’Cunha, MD, PhD Pedro Reck dos Santos, MD, PhD |
| author_sort | Renita Wilson, BS |
| collection | DOAJ |
| description | Background: Concomitant abdominal organ transplant of the liver, kidney, and/or pancreas with lung transplant (Con-AbLTx) may be considered for appropriate patients who present with end-stage disease of multiple organ systems. Most existing literature examines outcomes of combined lung-liver transplants, with little attention paid to other commonly transplanted abdominal organs, such as kidneys and pancreas. This study aims to examine post-transplant outcomes of patients submitted to Con-AbLTx to lung transplant (LTx)-only recipients. Methods: The international society for heart and lung transplantation (ISHLT) International Thoracic Organ Transplant Registry for Con-AbLTx and LTx-only was reviewed from January 1994 to June 2018. LTx-only recipients were propensity score matched 4:1 based on various patient characteristics. Data were analyzed with Fisher’s exact, Wilcoxon rank sum tests, Kaplan-Meier methods, and Cox proportional hazards where appropriate. Results: A total of 195 Con-AbLTx and 780 propensity-matched LTx-only cases were compared. LTx-only recipients demonstrated higher levels of bronchiolitis obliterans syndrome. Following transplant, Con-AbLTx required a longer hospital stay and post-transplant dialysis before discharge. LTx-only were more likely to experience graft failure from acute rejection or chronic rejection. Con-AbLTx experienced higher 1-year mortality than LTx-only counterparts, with the highest mortality seen in the concomitant lung/kidney group. Of concomitant transplants, lung/liver recipients had greater survival over time. Conclusions: Con-AbLTx has the potential to carry substantial morbidity. At 10 years post-transplant, there is no statistically significant difference in survival between LTx-only and Con-AbLTx recipients. Given limited organ availability and ethical considerations of simultaneous transplant, careful consideration for Con-AbLTx is paramount to achieve acceptable outcomes. |
| format | Article |
| id | doaj-art-03e8af7a0eb1473a8c92425a3e3f1ec5 |
| institution | Kabale University |
| issn | 2950-1334 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JHLT Open |
| spelling | doaj-art-03e8af7a0eb1473a8c92425a3e3f1ec52025-02-09T05:02:01ZengElsevierJHLT Open2950-13342025-02-017100200Concomitant abdominal organ transplantation alongside lung transplantation: An ISHLT transplant database analysisRenita Wilson, BS0J. Asher Jenkins, MD1Juan Maria Farina, MD2Blake Langlais, MS3Bashar Aqel, MD4Ashraf Omar, MD5Jonathan D’Cunha, MD, PhD6Pedro Reck dos Santos, MD, PhD7Mayo Clinic Alix School of Medicine, Phoenix, ArizonaDepartment of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix, ArizonaDepartment of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix, ArizonaDivision of Clinical Trials and Biostatistics, Mayo Clinic Arizona, Phoenix, ArizonaDivision of Gastroenterology and Hepatology, Mayo Clinic Arizona, Phoenix, ArizonaDivision of Transplant Pulmonology, Mayo Clinic Arizona, Phoenix, ArizonaDepartment of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix, ArizonaDepartment of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix, Arizona; Corresponding author: Pedro Reck dos Santos, MD, PhD, Department of Cardiothoracic Surgery, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054.Background: Concomitant abdominal organ transplant of the liver, kidney, and/or pancreas with lung transplant (Con-AbLTx) may be considered for appropriate patients who present with end-stage disease of multiple organ systems. Most existing literature examines outcomes of combined lung-liver transplants, with little attention paid to other commonly transplanted abdominal organs, such as kidneys and pancreas. This study aims to examine post-transplant outcomes of patients submitted to Con-AbLTx to lung transplant (LTx)-only recipients. Methods: The international society for heart and lung transplantation (ISHLT) International Thoracic Organ Transplant Registry for Con-AbLTx and LTx-only was reviewed from January 1994 to June 2018. LTx-only recipients were propensity score matched 4:1 based on various patient characteristics. Data were analyzed with Fisher’s exact, Wilcoxon rank sum tests, Kaplan-Meier methods, and Cox proportional hazards where appropriate. Results: A total of 195 Con-AbLTx and 780 propensity-matched LTx-only cases were compared. LTx-only recipients demonstrated higher levels of bronchiolitis obliterans syndrome. Following transplant, Con-AbLTx required a longer hospital stay and post-transplant dialysis before discharge. LTx-only were more likely to experience graft failure from acute rejection or chronic rejection. Con-AbLTx experienced higher 1-year mortality than LTx-only counterparts, with the highest mortality seen in the concomitant lung/kidney group. Of concomitant transplants, lung/liver recipients had greater survival over time. Conclusions: Con-AbLTx has the potential to carry substantial morbidity. At 10 years post-transplant, there is no statistically significant difference in survival between LTx-only and Con-AbLTx recipients. Given limited organ availability and ethical considerations of simultaneous transplant, careful consideration for Con-AbLTx is paramount to achieve acceptable outcomes.http://www.sciencedirect.com/science/article/pii/S2950133424001502concomitant transplantlung transplantabdominal transplantgraft survivalsimultaneous transplant |
| spellingShingle | Renita Wilson, BS J. Asher Jenkins, MD Juan Maria Farina, MD Blake Langlais, MS Bashar Aqel, MD Ashraf Omar, MD Jonathan D’Cunha, MD, PhD Pedro Reck dos Santos, MD, PhD Concomitant abdominal organ transplantation alongside lung transplantation: An ISHLT transplant database analysis JHLT Open concomitant transplant lung transplant abdominal transplant graft survival simultaneous transplant |
| title | Concomitant abdominal organ transplantation alongside lung transplantation: An ISHLT transplant database analysis |
| title_full | Concomitant abdominal organ transplantation alongside lung transplantation: An ISHLT transplant database analysis |
| title_fullStr | Concomitant abdominal organ transplantation alongside lung transplantation: An ISHLT transplant database analysis |
| title_full_unstemmed | Concomitant abdominal organ transplantation alongside lung transplantation: An ISHLT transplant database analysis |
| title_short | Concomitant abdominal organ transplantation alongside lung transplantation: An ISHLT transplant database analysis |
| title_sort | concomitant abdominal organ transplantation alongside lung transplantation an ishlt transplant database analysis |
| topic | concomitant transplant lung transplant abdominal transplant graft survival simultaneous transplant |
| url | http://www.sciencedirect.com/science/article/pii/S2950133424001502 |
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