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Comparing Right- Versus Left-First Implantation in Off-Pump Sequential Double-Lung Transplantation: An Observational Cohort Study

Friday, December 27, 2024

Submitted by

Akshay Patel

Source

Source Name: European Journal of Cardio-Thoracic Surgery

Source URL: https://pubmed.ncbi.nlm.nih.gov/39254629/

Author(s)

Jan Van Slambrouck, Herbert Decaluwé, Cedric Vanluyten, Christelle M Vandervelde, Michaela Orlitová, Hanne Beeckmans, Charlotte Schoenaers, Xin Jin, Roza S Makarian, Paul De Leyn, Hans Van Veer, Lieven Depypere, Ann Belmans, Bart M Vanaudenaerde, Robin Vos, Dirk Van Raemdonck, Laurens J. Ceulemans

The article evaluates the outcomes of a paradigm shift in lung transplantation. Traditionally, the lung with the lowest perfusion was implanted first to minimize intraoperative hemodynamic instability. However, this single-center study of 696 cases from 2008 to 2021 investigated the impact of consistently implanting the right lung first, irrespective of perfusion.

The main findings revealed that the right-first strategy significantly reduced the need for intraoperative extracorporeal membrane oxygenation (ECMO) during second-lung implantation and showed a trend toward reduced incidence of primary graft dysfunction (PGD) grade 3. Secondary outcomes, including survival and ICU stays, did not differ between groups.