Abstract OBJECTIVES CLAD is a major factor limiting long-term survival after heart-lung transplantation (HLTx). Whether lung retransplantation (LRTx) offers the same long-term results in HLTx recipients as in DLTx recipients remains unknown. The aim of this study was to compare outcomes of LRTx after HLTx and DLTx. METHODS We retrospectively reviewed charts of patients retransplanted at our institution in 2006–2023. Outcomes after LRTx, overall survival, and BOS-free survival were compared between HLTx and DLTx groups. RESULTS LRTx was performed in 60 patients, including 20 after HLTx and 40 after DLTx. Median post-retransplant follow-up was 3.54 years 1.37—6.79. Median time to retransplantation was significantly shorter in LRTx group (HLTx: 5.47 4.55—7.02 years vs DLTx: 2.77 1.55—5.46 years; P = 0.03). Overall in-hospital mortality was 5% (n = 3) with no significant difference between the groups. The two groups were similar for PGD Grade 2 or 3 at 72 h (HLTx: 17%; DLTx: 39%; P = 0.133), 1- and 5-year overall survival (HLTx: 70% and 54%; DLTx: 87% and 43%; P = 0.249) and 1- and 5-year BOS-free survival rates (HLTx: 70% and 40%; DLTx: 72% and 33%; P = 0.402). With LRTx after HLTx, 10-year freedom from coronary allograft vasculopathy (CAV) since the first transplant was 72%. CONCLUSIONS Overall survival and BOS-free survival benefits of LRTx were similar after DLTx or HLTx. LRTx in HLTx group did not lead to an increased risk of CAV. LRTx seems a good option for carefully selected patients with end-stage CLAD after HLTx to improve survival and quality of life.
Lenoir et al. (Thu,) studied this question.