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Outcomes of COPD Lung Transplant Recipients After Lung Volume Reduction Surgery^*

^* From the Inova Heart and Lung Transplant Center (Drs. Nathan, Ahmad, Burton, and Barnett), Falls Church; and the United Network for Organ Sharing (Dr. Edwards), Richmond, VA.

Correspondence to: Steven D. Nathan, MD, FCCP, Medical Director, Lung Transplant Program, Inova Heart and Lung Transplant Center, Inova Fairfax Hospital, 3300 Gallows Rd, Falls Church, VA 22042; e-mail: steven.nathan{at}inova.com

Study objectives: We sought to assess the outcomes of COPD lung transplant recipients who had previously undergone lung volume reduction surgery (LVRS), and to compare these patients to those COPD lung recipients who had not previously undergone LVRS.

Design: Retrospective analysis of the United Network for Organ Sharing transplant database over the period between October 25, 1999, and December 31, 2002.

Patients: All COPD patients who were listed and underwent transplantation during the time period were analyzed and categorized according to who did and did not have a history of LVRS. The two groups were compared for demographics, severity of illness, and various measures of outcomes after transplantation, including survival.

Results: There were 791 COPD patients who underwent transplantation, of whom 50 had a history of LVRS. The two groups had similar demographics and severity of disease. There was no difference in the need for reoperation, hospital length of stay, or survival between the groups.

Conclusion: A history of LVRS does not impact on outcomes after lung transplantation and should not influence a patient’s candidacy for transplantation. Similarly, a patient’s potential need for lung transplantation should not impact on the decision-making process for undergoing LVRS.

Key Words: chronic obstructive lung transplantation • cohort studies • mortality • pneumonectomy • pulmonary disease • pulmonary emphysema • surgery • survival analysis

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