Advertisement

Single lung transplantation for lymphangioleiomyomatosis: a single-center experience in Japan

  • Hisashi Oishi
  • Tatsuaki Watanabe
  • Yasushi Matsuda
  • Masafumi Noda
  • Yutaka Ejima
  • Yoshikatsu Saiki
  • Kuniaki Seyama
  • Takashi Kondo
  • Yoshinori Okada
Original Article
  • 28 Downloads

Abstract

Purpose

Lung transplantation is accepted as an effective modality for patients with end-stage pulmonary lymphangioleiomyomatosis (LAM). Generally, bilateral lung transplantation is preferred to single lung transplantation (SLT) for LAM because of native lung-related complications, such as pneumothorax and chylothorax. It remains controversial whether SLT is a suitable surgical option for LAM. The objective of this study was to evaluate the morbidity, mortality and outcome after SLT for LAM in a lung transplant center in Japan.

Methods

We reviewed the records of 29 patients who underwent SLT for LAM in our hospital between March, 2000 and November, 2017. The data collected included the pre-transplant demographics of recipients, surgical characteristics, complications, morbidity, mortality and survival after SLT for LAM.

Results

The most common complication after SLT for LAM was contralateral pneumothorax (n = 7; 24.1%). Six of these recipients were treated successfully with chest-tube placement and none required surgery for the pneumothorax. The second-most common complication was chylous pleural effusion (n = 6; 20.7%) and these recipients were all successfully treated by pleurodesis. The 5-year survival rate after SLT for LAM was 79.5%.

Conclusion

LAM-related complications after SLT for this disease can be managed. SLT is a treatment option and may improve access to lung transplantation for patients with end-stage LAM.

Keywords

Lymphangioleiomyomatosis Single lung transplantation Pneumothorax Chylous pleural effusion 

Notes

Acknowledgements

We thank Brent Bell for assistance with editing this manuscript.

Compliance with ethical standards

Conflict of interest

Hisashi Oishi and his co-authors have no conflicts of interest.

References

  1. 1.
    Kpodonu J, Massad MG, Chaer RA, Caines A, Evans A, Snow NJ, et al. The US experience with lung transplantation for pulmonary lymphangioleiomyomatosis. J Hear Lung Transpl. 2005;24:1247–53.CrossRefGoogle Scholar
  2. 2.
    Benden C, Rea F, Behr J, Corris PA, Reynaud-Gaubert M, Stern M, et al. Lung transplantation for lymphangioleiomyomatosis: the European experience. J Hear lung Transpl. 2009;28:1–7.CrossRefGoogle Scholar
  3. 3.
    Yusen RD, Edwards LB, Kucheryavaya AY, Benden C, Dipchand AI, Goldfarb SB, et al. The Registry of the International Society for Heart and Lung Transplantation: thirty-second Official Adult Lung and Heart-Lung Transplantation Report–2015; focus theme: early Graft Failure. J Hear Lung Transpl. 2015;34:1264–77.CrossRefGoogle Scholar
  4. 4.
    Sato M, Okada Y, Oto T, Minami M, Shiraishi T, Nagayasu T, et al. Registry of the Japanese Society of Lung and Heart–Lung Transplantation: official Japanese lung transplantation report, 2014. Gen Thorac Cardiovasc Surg. 2014;62:594–601.CrossRefPubMedGoogle Scholar
  5. 5.
    Pechet TT, Meyers BF, Guthrie TJ, Battafarano RJ, Trulock EP, Cooper JD, et al. Lung transplantation for lymphangioleiomyomatosis. J Heart Lung Transpl. 2004;23:301–8.CrossRefGoogle Scholar
  6. 6.
    Boehler A, Speich R, Russi EW, Walter W. Lung transplantation for lymphangioleiomyomatosis. N Engl J Med. 1996;335:1275–80.CrossRefPubMedGoogle Scholar
  7. 7.
    Reynaud-Gaubert M, Mornex J-F, Mal H, Treilhaud M, Dromer C, Quétant S, et al. Lung transplantation for lymphangioleiomyomatosis: the French experience. Transplantation. 2008;86:515–20.CrossRefPubMedGoogle Scholar
  8. 8.
    Machuca TN, Losso MJ, Camargo SM, Schio SM, Melo IA, Hochhegger B, et al. Lung transplantation for lymphangioleiomyomatosis: single-center Brazilian experience with no chylothorax. Transpl Proc. 2011;43:236–8.CrossRefGoogle Scholar
  9. 9.
    Ohara T, Oto T, Miyoshi K, Tao H, Yamane M, Toyooka S, et al. Sirolimus ameliorated post lung transplant chylothorax in lymphangioleiomyomatosis. Ann Thorac Surg. 2008;86:e7–8.CrossRefGoogle Scholar
  10. 10.
    Harari S, Elia D, Torre O, Bulgheroni E, Provasi E, Moss J. Sirolimus therapy for patients with lymphangioleiomyomatosis leads to loss of chylous ascites and circulating LAM cells. Chest. 2016;150:e29–e32 (American College of Chest Physicians).CrossRefPubMedGoogle Scholar
  11. 11.
    Taveira-dasilva AM, Hathaway O, Stylianou M, Moss J. Changes in lung function and chylous effusions in patients with lymphangioleiomyomatosis treated with sirolimus. Ann Intern Med. 2011;154:797–805.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Ando K, Kurihara M, Kataoka H, Ueyama M, Togo S, Sato T, et al. Efficacy and safety of low-dose sirolimus for treatment of lymphangioleiomyomatosis. Respir Investig. 2013;51:175–83.CrossRefPubMedGoogle Scholar
  13. 13.
    Radzikowska E. Lymphangioleiomyomatosis: new treatment perspectives. Lung. 2015;193:467–75.CrossRefPubMedGoogle Scholar
  14. 14.
    Ito T, Suno M, Sakamoto K, Yoshizaki Y, Yamamoto K, Nakanishi R, et al. Therapeutic effect of sirolimus for lymphangioleiomyomatosis remaining in the abdominopelvic region after lung transplantation: a case report. Transpl Proc. 2016;48:271–4.CrossRefGoogle Scholar
  15. 15.
    King-Biggs MB, Dunitz JM, Park SJ, Kay Savik S, Hertz MI. Airway anastomotic dehiscence associated with use of sirolimus immediately after lung transplantation. Transplantation. 2003;75:1437–43.CrossRefPubMedGoogle Scholar
  16. 16.
    Groetzner J, Kur F, Spelsberg F, Behr J, Frey L, Bittmann I, et al. Airway anastomosis complications in de novo lung transplantation with sirolimus-based immunosuppression. J Hear Lung Transpl. 2004;23:632–8.CrossRefGoogle Scholar
  17. 17.
    Thabut G, Christie JD, Ravaud P, Castier Y, Brugière O, Fournier M, et al. Survival after bilateral versus single lung transplantation for patients with chronic obstructive pulmonary disease: a retrospective analysis of registry data. Lancet. 2008;371:744–51.CrossRefPubMedGoogle Scholar
  18. 18.
    Munson JC, Christie JD, Halpern SD. The societal impact of single versus bilateral lung transplantation for chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2011;184:1282–8.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Thabut G, Christie JD, Ravaud P, Castier Y. Annals of internal medicine article survival after bilateral versus single-lung transplantation for. Ann Intern Med. 2009;151:767–74.CrossRefPubMedGoogle Scholar
  20. 20.
    Ando K, Okada Y, Akiba M, Kondo T, Kawamura T, Okumura M, et al. Lung transplantation for lymphangioleiomyomatosis in Japan. PLoS One. 2016;11:1–14.Google Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018
corrected publication June 2018

Authors and Affiliations

  1. 1.Department of Thoracic Surgery, Institute of Development, Aging and CancerTohoku UniversityAobakuJapan
  2. 2.Department of AnesthesiologyTohoku University HospitalSendaiJapan
  3. 3.Department of Cardiovascular SurgeryTohoku University Graduate School of MedicineSendaiJapan
  4. 4.Division of Respiratory Medicine, Faculty of Medicine and Graduate School of MedicineJuntendo UniversityTokyoJapan
  5. 5.Department of Thoracic SurgeryTohoku Medical and Pharmaceutical UniversitySendaiJapan

Personalised recommendations