Short- and long-term outcomes of 1000 adult lung transplant recipients at a single center

Daniel Kreisel, Alexander S. Krupnick, Varun Puri, Tracey J. Guthrie, Elbert P. Trulock, Bryan F. Meyers, G. Alexander Patterson

Research output: Contribution to journalArticlepeer-review

109 Scopus citations


Objective: Lung transplantation has become accepted therapy for end-stage pulmonary disease. The objective of this study was to review a single-institution experience of adult lung transplants. Methods: We reviewed 1000 adult lung transplants that were performed at Washington University between July 1988 and January 2009. Results: Transplants were performed for emphysema (52%), cystic fibrosis (18.2%), pulmonary fibrosis (16.1%), and pulmonary vascular disease (7.2%). Overall recipient age was 48 ± 13 years with an increase from 43 ± 12 years (July 1988-November 1993) to 50 ± 14 years (June 2005-January 2009). Overall incidence of primary graft dysfunction was 22.1%. Hospital mortality was higher for patients who had primary graft dysfunction (primary graft dysfunction, 13.6%; no primary graft dysfunction, 4%; P < .001). Freedom from bronchiolitis obliterans syndrome was 84% at 1 year, 38.2% at 5 years, and 12.2% at 10 years. Survival at 1, 5, 10, and 15 years was 84%, 56.4%, 32.2%, and 17.8%, respectively. Five-year survival improved from 49.6% (July 1988-November 1993) to 62.1% (October 2001-June 2005). Primary graft dysfunction was associated with lower survival at 1, 5, and 10 years (primary graft dysfunction: 72.8%, 43.9%, and 18.7%, respectively; no primary graft dysfunction: 87.1%, 59.8%, and 35.7%, respectively, P < .001) and lower rates of freedom from bronchiolitis obliterans syndrome (primary graft dysfunction: 78%, 27.5%, and 8.5%, respectively; no primary graft dysfunction: 85.4%, 40.7%, and 13.1%, respectively, P = .007). Conclusions: Five-year survival has improved over the study period, but long-term outcomes are limited by bronchiolitis obliterans syndrome. Primary graft dysfunction is associated with higher rates of bronchiolitis obliterans syndrome and impaired short- and long-term survival. A better understanding of primary graft dysfunction and bronchiolitis obliterans syndrome is critical to improve outcomes.

Original languageEnglish
Pages (from-to)215-222
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Issue number1
StatePublished - Jan 2011


  • BOS
  • COPD
  • DCD
  • PGD
  • bronchiolitis obliterans syndrome
  • chronic obstructive pulmonary disease
  • donation after cardiac death
  • primary graft dysfunction


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