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Double-Lung Transplant Better for Long-Term Survival

But finding is controversial, since bilateral procedure could halve number of recipients

WEDNESDAY, April 22 (HealthDay News) -- Lung transplant patients who receive two lungs are twice as likely to live more than 10 years than patients who receive one lung are, Johns Hopkins transplant surgeons say.

"Our results suggest that double-lung transplants have a long-term advantage, and surgeons should consider bilateral lung transplants whenever possible," senior investigator Dr. Ashish Shah, an associate professor at the Johns Hopkins University School of Medicine and its Heart Institute, said in a Hopkins news release.

The finding from their analysis of patient records for all single- and double-lung transplants performed in Canada and the United States from 1987 to 1997 is potentially controversial. That's because there's a shortage of lung donors, and promoting more double-lung transplants could almost halve the number of potential lung recipients.

"Not all lung recipients necessarily need a bilateral transplant. Many people with chronic obstructive pulmonary disease, including emphysema and different kinds of pulmonary fibrosis, can survive with just one lung being replaced, while other lung diseases, such as cystic fibrosis, usually require transplantation of both lungs. But double-lung transplants clearly perform better over time," Shah said.

"What we're after here is to find as many factors as possible that support long-term survival, so that we maximize the gains in average life span for all our patients."

Shah and colleagues also found that a perfect or near perfect match between the donor's and recipient's immune-activating protein antigens and having a college education increases the chances for long-term survival by 38 percent and 40 percent, respectively.

Currently, about 17 percent of all lung transplant patients survive 10 years or longer. That's "pretty good, but not good enough," Shah said.

The study was presented Wednesday at the annual meeting of the International Society for Heart & Lung Transplantation, in Paris.

More information

The U.S. National Heart, Lung, and Blood Institute has more about lung transplantation.

-- Robert Preidt

SOURCE: Johns Hopkins Medicine, news release, April 22, 2009

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