February 29, 2008

Double Lung Transplant Better for Younger COPD Patients

FRIDAY, Feb. 29 (HealthDay News) -- A double lung transplant leads to longer survival than a single lung transplant in patients younger than 60 who are in the final stages of chronic obstructive pulmonary disease (COPD), French researchers say.

Double and single lung transplants are both recognized as treatment options for COPD, but it wasn't clear which procedure gave patients the longest survival time, according to background information in the study. Reports suggest that between 1995 and 2006, about 46 percent of lung transplants were done to treat patients with COPD.

Of the 9,883 patients in this study, 3,525 had a bilateral lung transplant (BLT), and 6,358 had a single lung transplant (SLT). All the transplants took place between 1987 and 2006.

Overall, the median survival time after BLT was 6.41 years, compared to 4.59 years after SLT. However, the researchers also found this difference was much less pronounced in patients aged 60 and older.

"Bilateral lung transplantation leads to longer survival than single lung transplantation in patients with COPD, especially those who are younger than 60 years ... Any potential survival benefit of bilateral lung transplantation for individuals with COPD must be weighed against the potential societal benefits of allocation of organs to patients with advanced lung diseases," the study authors concluded.

The study was published in this week's issue of The Lancet.

Surgical lung-volume reduction, use of endobronchial valves, pulmonary rehabilitation, and smoking cessation programs are among the alternatives to lung transplantation, Dr. E. Clinton Lawrence, of the McKelvey Center for Lung Transplantation and Pulmonary Vascular Diseases at Emory University School of Medicine in Atlanta, wrote in an accompanying editorial.

"Lung transplantation is an imperfect solution for COPD and other diseases, with a five-year survival rate of about 50 percent. There is a limited supply of organs suitable for transplantation, and patients, usually not those with COPD, die on waiting lists. Diminution of demand through smoking prevention programs is a far better alternative to lung transplantation," Lawrence wrote.

More information

The American Lung Association has more about COPD.

-- Robert Preidt
SOURCE: The Lancet, news release, Feb. 29, 2008
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