Simple strategy could improve outcomes in lung transplant for ILD

A specific donor-to-recipient size-matching strategy based on a predicted total lung capacity (D-R pTLC) ratio of 0.8≥ <1.2 improved outcomes after double lung transplant (DLTX) in patients with restrictive lung disease, according to a study.

In this retrospective, single-center, cohort study, 450 patients undergoing lung transplants were included, with 450 patients undergoing DLTX and 146 undergoing single lung transplant (SLTx).

Size-matching was achieved in 78% and 47% of patients undergoing DLTx and SLTx, respectively. After a size-matched DLTx, there was a significant improvement in overall survival (P = 0.007) and chronic lung allograft dysfunction-free survival (P < 0.001) compared to patients with D-R pTLC ratios <0.8 or ≥1.2. For patients undergoing SLTX, size-matching based on a D-R pTLC ratio 0.8≥ <1.0 did not significantly improve survival.

“This [approach] is simple to do, and if applied clinically, could improve overall outcomes in lung transplantation,” the authors concluded.

Reference
Riddell P, Ma J, Dunne B, et al. A simplified strategy for donor-recipient size-matching in lung transplant for interstitial lung disease. J Heart Lung Transplant. 2021;S1053-2498(21)02388-3. doi: 10.1016/j.healun.2021.06.013. Epub ahead of print. PMID: 34301464.