Indications for and outcomes after combined lung and liver transplantation: a single-center experience on 13 consecutive cases

Transplantation. 2008 Feb 27;85(4):524-31. doi: 10.1097/TP.0b013e3181636f3f.


Background: Combined lung and liver transplantation (Lu-LTx) is a therapeutic option for selected patients with coexisting lung and liver disease. For several reasons, Lu-LTx is performed in few centers and information about the technical issues, posttransplant management and long-term outcomes associated with this procedure is limited.

Methods: We analyzed data from 13 consecutive patients who underwent combined Lu-LTx at Hannover Medical School (Hannover, Germany) between April 1999 and December 2003. The main indications were cystic fibrosis, alpha1-proteinase inhibitor deficiency and portopulmonary hypertension. All patients had advanced cirrhosis and severe pulmonary disease manifestation.

Results: Ten patients received a sequential double Lu-LTx, one patient received a single Lu-LTx, one received a double lung and split liver transplantation, and one received an en-bloc heart-lung and liver transplantation. Immunosuppression was based on cyclosporine in a triple/quadruple regimen. Postoperative surgical complications occurred in eight patients. There were two perioperative deaths; two patients died during the first year on day 67 and 354, respectively, and one patient died at month 53. The overall patient survival rates at 1, 3, and 5 years were 69%, 62%, and 49%, respectively.

Conclusion: Combined Lu-LTx is a therapeutic option for highly selected patients with end-stage lung and liver disease with acceptable long-term outcome.

MeSH terms

  • Adult
  • Female
  • Graft Rejection / epidemiology
  • Graft Survival
  • Heart-Lung Transplantation / methods
  • Heart-Lung Transplantation / mortality
  • Humans
  • Hypertension, Pulmonary / complications
  • Hypertension, Pulmonary / surgery
  • Infections / epidemiology
  • Liver Diseases / complications
  • Liver Diseases / surgery
  • Liver Transplantation / methods*
  • Liver Transplantation / mortality
  • Lung Transplantation / methods*
  • Lung Transplantation / mortality
  • Male
  • Middle Aged
  • Postoperative Complications / classification
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Survival Analysis