The Cardiothoracic Surgeon (Dec 2023)
Exploring long-term outcomes in COPD patients: a comprehensive narrative review of bilateral and single lung transplantation
Abstract
Abstract Background Millions of people throughout the world suffer from the common and fatal respiratory disorder known as chronic obstructive pulmonary disease (COPD). Lung transplantation gives hope to individuals with end-stage COPD, with both bilateral lung transplantation and single lung transplantation being effective procedures. The complexity of chronic obstructive pulmonary disease is underscored by various factors influencing transplant outcomes, including patient characteristics, donor features, and complications post-transplantation. Methodology This narrative review explores recent studies on bilateral and single lung transplantation in chronic obstructive pulmonary disease patients, focusing on research published after 2020. Databases like PubMed and Google Scholar were used with keywords such as “COPD,” “lung transplantation,” “bilateral lung transplantation,” and “single lung transplantation” guided the research, emphasizing survival rates, quality of life, and post-transplant complications. Five selected articles encompassing 63,426 patients were examined, evaluating methodological variations among the studies. Results The selected studies showed no unanimous agreement on whether bilateral or single lung transplantation is superior for chronic obstructive pulmonary disease patients. Bilateral lung transplantation exhibited higher mid- and long-term survival rates, influenced significantly by age, comorbidities, and disease profiles. Improved quality of life was observed with bilateral transplantation, but this outcome depended on external circumstances. Post-transplant complications emphasized the need for rigorous post-transplant care. Conclusions Individualized assessments are crucial when choosing between bilateral and single lung transplantation for chronic obstructive pulmonary disease patients. Despite varying research results, bilateral transplantation generally offers better survival and quality of life. Informed decisions require personalized post-transplant care, standardized reporting, and consistent research methods. Emphasizing donor management, preventing chronic lung allograft dysfunction, and prioritizing patient-centered care is vital. Collaborative efforts and patient-focused strategies are essential for improving long-term outcomes in these patients undergoing lung transplantation.
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