It more than doubles an organ recipient’s chances of extending his life by over a decade. The finding is potentially controversial, researchers say, because there is already a shortage of organ donors, and more widespread use of bilateral lung transplants could nearly halve the potential number of beneficiaries.
“Our results suggest that double-lung transplants have a long-term advantage, and surgeons should consider bilateral lung transplants whenever possible,” says study senior investigator Ashish Shah. A key advantage in double-lung transplants over single-lung transplants is that residual disease is not left behind in the spared lung. Moreover, when both lungs are replaced, the new lungs, which must breathe together as a pair, are already adapted to each other.
The study emerged from an analysis of 836 so-called long-term survivors of lung transplants, men and women who have lived at least a decade after transplant surgery between 1987 and 1997, an extended period for which detailed medical histories are now available. “Until now, we never really knew what factors distinguished the long-term survivors from those who succumbed earlier, to either organ rejection or death,” says Shah.
Among the team’s other key findings are that a perfect or near perfect match between the donor’s immune-activating protein antigens with a recipient’s and having a college education increases chances for long-term survival by 38 percent and 40 percent, respectively.
Lead study investigator Eric Weiss says that a patient’s education, though key, is more likely a cover or surrogate, masking some other factor or combination of factors that are accounting for the increased longevity. Possible explanations, he says, are that better educated people may have better health insurance and access to care than those with less formal schooling, or that people with degrees are better at keeping their physician appointments on schedule, taking their medications as prescribed and sooner alerting their physicians to problems.
MEDICA.de; Source: Johns Hopkins Medicine