Tuberc Respir Dis.  2019 Oct;82(4):348-356. 10.4046/trd.2019.0016.

Long-Term Outcomes of Adult Lung Transplantation Recipients: A Single-Center Experience in South Korea

Affiliations
  • 1Division of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. shimts@amc.seoul.kr
  • 2Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. sipark@amc.seoul.kr
  • 3Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 4Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 5Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 6Organ Transplantation Center, Asan Medical Center, Seoul, Korea.

Abstract

BACKGROUND
Recently, the number of lung transplants in South Korea has increased. However, the long-term outcome data is limited. In this study, we aimed to investigate the long-term outcomes of adult lung transplantation recipients.
METHODS
Among the patients that underwent lung transplantation at a tertiary referral center in South Korea between 2008 and 2017, adults patient who underwent deceased-donor lung transplantation with available follow-up data were enrolled. Their medical records were retrospectively reviewed.
RESULTS
Through eligibility screening, we identified 60 adult patients that underwent lung (n=51) or heart-lung transplantation (n=9) during the observation period. Idiopathic pulmonary fibrosis (46.7%, 28/60) was the most frequent cause of lung transplantation. For all the 60 patients, the median follow-up duration for post-transplantation was 2.6 years (range, 0.01-7.6). During the post-transplantation follow-up period, 19 patients (31.7%) died at a median duration of 194 days. The survival rates were 75.5%, 67.6%, and 61.8% at 1 year, 3 years, and 5 years, respectively. Out of the 60 patients, 8 (13.3%) were diagnosed with chronic lung allograft dysfunction (CLAD), after a mean duration of 3.3±2.8 years post-transplantation. The CLAD development rate was 0%, 17.7%, and 25.8% at 1 year, 3 years, and 5 years, respectively. The most common newly developed post-transplantation comorbidity was the chronic kidney disease (CKD; 54.0%), followed by diabetes mellitus (25.9%).
CONCLUSION
Among the adult lung transplantation recipients at a South Korea tertiary referral center, the long-term survival rates were favorable. The proportion of patients who developed CLAD was not substantial. CKD was the most common post-transplantation comorbidity.

Keyword

Lung Transplantation; Survival; Chronic Lung Allograft Dysfunction; Chronic Kidney Disease

MeSH Terms

Adult*
Allografts
Comorbidity
Diabetes Mellitus
Follow-Up Studies
Heart-Lung Transplantation
Humans
Idiopathic Pulmonary Fibrosis
Korea*
Lung Transplantation*
Lung*
Mass Screening
Medical Records
Renal Insufficiency, Chronic
Retrospective Studies
Survival Rate
Tertiary Care Centers

Figure

  • Figure 1 Study flow chart. LDLLT: living-donor lobar lung transplantation.

  • Figure 2 Kaplan-Meier survival rates of 60 patients who underwent lung transplantation.

  • Figure 3 Kaplan-Meier estimates for chronic lung allograft dysfunction (CLAD) development of 60 patients who underwent lung transplantation.


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