Single-lung transplantation in emphysema: Retrospective study analyzing survival and waiting list mortality

Table 1 Demographic, clinical characteristics, and complications of patients in the single-center series n (%)

	Study cohort	Single-lung	Double-lung	P-value
	n = 73	n = 40	n = 33
Age in years (mean ± SD)	54.9 ± 7.1	57.3 ± 6.1	51.9 ± 7.3	0.001
Gender (male)	62 (85%)	33 (82.5%)	29 (87.9%)	0.520
Underlying disease				0.940
α1-antitrypsin deficiency	18 (24.6%)	10 (25%)	8 (24.2%)
Chronic obstructive pulmonary disease	55 (75.3%)	30 (75%)	25 (75.2%)

Table 2 Survival probability according to type of transplant

Time until	Single-lung		Double-lung
transplantation	No. at risk	Survival probability	No. at risk	Survival probability
1 yr	34	85.0%	26	78.8%
2 yr	31	77.5%	24	72.7%
3 yr	29	72.5%	22	66.7%
4 yr	23	57.5%	20	60.6%
5 yr	20	52.4%	17	51.5%

Log-rank test = 0.001; P = 0.976.

Table 3 Cox regression analysis to predict mortality adjusting for different variables

	B	SE	Wald	P-value	HR	95%CI HR
Age in years	0.040	0.024	2.780	0.095	1.041	0.993-1.091
Gender (female)	0.475	0.391	1.481	0.224	1.609	0.748-3.459
Underlying disease (COPD)	0.737	0.407	3.278	0.070	2.088	0.941-4.651
Type of transplant (double-lung)	-0.086	0.345	0.063	0.802	0.917	0.466-1.804

COPD: Chronic obstructive pulmonary disease; B: Regression coefficient; SE: Standard error; HR: Hazard ratio.

Table 4 Univariate and multivariate analysis of postoperative complications in relation to type of transplant n (%)

	Single-lung n = 40	Double-lung n = 33	Univariate analysis	Multivariate analysis1
			P-value	P-value	OR (95%CI)
Complications during follow-up
Bronchiolitis obliterans syndrome	22 (55.0)	16 (48.5)	0.579	0.475	0.7 (0.2-1.9)
Acute rejection episodes	18 (45.0)	18 (54.5)	0.417	0.397	1.6 (0.6-4.4)
Bacterial respiratory infections	27 (67.5)	22 (68.8)	0.910	0.597	0.7 (0.2-2.3)
CMV infection/disease	19 (47.5)	9 (27.3)	0.077	0.104	0.4 (0.1-1.2)
Fungal infections	12 (30.0)	8 (24.2)	0.583	0.807	0.9 (0.3-2.7)

¹Multivariate logistic regression analysis adjusted for age, gender and underlying disease. CMV: Cytomegalovirus.

Table 5 Waiting list status of patients diagnosed with chronic obstructive pulmonary disease, emphysema or α1-antitrypsin deficiency

		Final waiting list status				Total
		Active	Excluded	Deceased	Transplanted
SL	No.	25	25	9	284	343
	Total SL %	7.3%	7.3%	2.6%	82.8%	100.0%
DL	No.	35	51	40	532	658
	Total DL %	5.3%	7.8%	6.1%	80.9%	100.0%
Total	No.	60	76	49	816	1001
	Total %	6.0%	7.6%	4.9%	81.5%	100.0%

Lung transplantation waiting list, Spain 1999-2012. SL: Single-lung; DL: Double-lung.