Single versus bilateral lung transplantation for end-stage chronic obstructive pulmonary disease: A systematic review and meta-analysis
- VernacularTitle:单肺与双肺移植治疗终末期慢性阻塞性肺疾病的系统评价与Meta分析
- Author:
Yuhan GENG
1
;
Long MA
2
;
Yongming MA
2
;
Jingyang SUN
2
;
Bin LIU
1
;
Yi YANG
3
;
Gang JIN
3
;
Zijiang ZHU
4
Author Information
1. Ningxia Medical University, Yinchuan, 750000, P. R. China
2. The First Clinical Medical College of Gansu University of Chinese Medicine, Lanzhou, 730000, P. R. China
3. The Second Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, 730000, P. R. China
4. Department of Thoracic Surgery, Gansu Provincial Central Hospital, Lanzhou, 730000, P. R. China
- Publication Type:Journal Article
- Keywords:
Single lung transplantation;
bilateral lung transplantation;
chronic obstructive pulmonary disease;
overall survival;
complication;
systematic review/meta-analysis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2024;31(11):1637-1644
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically evaluate the efficacy and safety of single and bilateral lung transplantation in the treatment of end-stage chronic obstructive pulmonary disease (COPD). Methods Chinese and English databases were searched by computer, including PubMed, Web of Science, The Cochrane Library, EMbase, CNKI, Wanfang database, VIP database and CBM. Case-control studies on single lung transplantation or bilateral lung transplantation for COPD were collected from the inception to July 31, 2022. We evaluated the quality of the literature via Newcastle-Ottawa Scale (NOS). All results were analyzed using Review Manager V5.3 and STATA 17.0. Results A total of 8 studies were included covering 14076 patients, including 8326 patients in the single lung transplantation group and 5750 patients in the bilateral lung transplantation group. NOS scores were≥6 points. The results of meta-analysis showed that there was no statistical difference in the postoperative 1-year survival between the two groups (P=0.070). The 2-year survival rate (P=0.002), 3-year survival rate (P<0.001), 5-year survival rate (P<0.001), overall survival rate (P＜0.001), postoperative forced expiratory volume in one second/predicted value (P<0.001), postoperative forced vital capacity (P<0.001), and postoperative 6-minute walking distance (P=0.002) were lower or shorter than those in the bilateral lung transplantation group, the postoperative intubation time (P=0.030) was longer than that in the bilateral lung transplantation group. Bilateral lung transplantation group showed better surgical results. There was no statistical difference in the mortality, obliterative bronchiolitis, length of hospitalization, primary graft dysfunction, or postoperative adverse events (P>0.05). Conclusion Bilateral lung transplantation is associated with better long-term survival and postoperative lung function compared with single lung transplantation. In-hospital mortality and postoperative complications are similar between them.
