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

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Abstract

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.

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Authors and Affiliations

  1. Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, 2-2-L5 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Hideki Nagata, Takashi Kanou, Eriko Fukui, Toru Kimura, Naoko Ose, Soichiro Funaki & Yasushi Shintani

Authors
  1. Hideki Nagata
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  2. Takashi Kanou
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  3. Eriko Fukui
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  4. Toru Kimura
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  5. Naoko Ose
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  6. Soichiro Funaki
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  7. Yasushi Shintani
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Corresponding author

Correspondence to Takashi Kanou.

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The authors declare no conflicts of interest in association with the present study.

Ethical approval

The study protocol was approved by the Institutional Review Board of the Ethics Committee of Osaka University Hospital (control number: 10026).

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Nagata, H., Kanou, T., Fukui, E. et al. Native lung surgery after single lung transplantation: clinical characteristics and outcomes. Surg Today (2024). https://doi.org/10.1007/s00595-024-02828-8

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