Transplant Trial Watch

Bilateral lung transplantation provides better long-term survival and pulmonary function than single lung transplantation: A systematic review and meta-analysis.

Yu, H., et al. (2019).

Transplantation 24:24.


Aims
This systematic review aimed to compare bilateral lung transplantation (BLT) and single lung transplantation (SLT) to identify the better clinical choice for lung transplantation.

Interventions
The Web of Science, EMBASE, Cochrane Library, Ovid MEDLINE, PubMed, ScienceDirect, and Google Scholar database engines were reviewed for randomised controlled trials on single lung transplantation (SLT) and bilateral lung transplantation (BLT) ( the search was conducted from inception to January 5, 2019.)

Participants
Thirty studies including 1980 recipients in the SLT group and 2112 recipients in the BLT group of lung transplant patients.

Outcomes
Outcomes assessed included: perioperative indexes, postoperative complications, pulmonary functions and survival.

Follow-up
5 Years

CET Conclusions
This systematic review identified cohort studies comparing the outcomes of bilateral versus single lung transplantation. From 30 studies, the authors conclude that long-term and BOS-free survival (4-5 years) is improved with bilateral lung transplantation. Surgical time and post-operative ITU stay were lower in the single-lung group. This is an interesting study and the methodology in general is good. The obvious caveat is that these are (necessarily) retrospective cohort studies and there is likely to be an element of selection bias. There is heterogeneity in some analyses which is not explained. It is possible that SLT may be as suitable in some subpopulations that could not be examined in these data.

Trial registration
PROSPERO - CRD42019131582

Funding source
Industry funded