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Double-lung versus heart–lung transplantation for end-stage cardiopulmonary disease: a systematic review and meta-analysis

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Abstract

We compared posttransplant outcomes following double-lung transplantation (DLTx) and heart–lung transplantation (HLTx), based on a search of PubMed, Cochrane Library, and Embase, from inception to March 8, 2022, for studies that report outcomes of these procedures. We then performed a meta-analysis of baseline characteristics and posttransplant outcomes. Subgroup analyses were implemented according to indication, publication year, and center. This study was registered on PROSPERO (number CRD42020223493). Ten studies were included in this meta-analysis, involving 1230 DLTx patients and 1022 HLTx patients. The DLTx group was characterized by older donors (P = 0.04) and a longer allograft ischemia time (P < 0.001) than the HLTx group. The two groups had comparable 1-year, 3-year, 5-year, 10-year survival rates (all P > 0.05), with similar results identified in subgroup analyses. We found no significant differences in 1-year, 5-year, and 10-year chronic lung allograft dysfunction (CLAD)-free survival, length of intensive care unit stay and hospital stay, length of postoperative ventilation, in-hospital mortality, or surgical complications between the groups (all P > 0.05). Thus, DLTx provides similar posttransplant survival to HLTx for end-stage cardiopulmonary disease. These two procedures have a comparable risk of CLAD and other posttransplant outcomes.

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Acknowledgements

We thank all authors of the articles that were included in this systematic review and meta-analysis, especially Dr. Dirk Van Raemdonck and colleagues (Department of Thoracic Surgery, University Hospitals Leuven) who provided unpublished data for this study after we contacted them by email. We appreciate the American Journal Experts (https://secure.aje.com/cn/researcher/) for editing the English text of a draft of this manuscript.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Author notes

  1. Hao-Ji Yan, Xiang-Yun Zheng and Heng Huang have contributed equally.

Authors and Affiliations

  1. Department of Thoracic Surgery, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, China

    Hao-Ji Yan & Dong Tian

  2. Heart and Lung Transplant Research Laboratory, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China

    Hao-Ji Yan, Xiang-Yun Zheng, Heng Huang, Lin Xu, Hong-Tao Tang, Jun-Jie Wang, Cai-Han Li, Sheng-Xuan Zhang, Si-Yi Fu & Dong Tian

  3. Department of Cardiothoracic Intensive Care Unit, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China

    Hong-Ying Wen

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Yan, HJ., Zheng, XY., Huang, H. et al. Double-lung versus heart–lung transplantation for end-stage cardiopulmonary disease: a systematic review and meta-analysis. Surg Today 53, 1001–1012 (2023). https://doi.org/10.1007/s00595-022-02579-4

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