Table 1 Comparison of single vs bilateral lung transplantation for COPD
Author, year | Rania Mansour, 2023 [9] | Sudeep Mutyala, 2021 [10] | Yu-Chi Fang, 2023 [11] | Travis D. Hull, 2022 [12] | Luke J. Benvenuto, 2020 [13] |
|---|---|---|---|---|---|
Study follow-up time | Searched for articles from their inception to July 2022 | February 2012 to March 2020 | Studies published before the year 2000 and those with less than 50 patients | Organ sharing database between 2005 and 2018 | May 4, 2005 to June 30, 2017 |
Total number of patients or studies | Seven studies, total of 10,652 patients | 186 patients | 15 studies | 10,023 patients | 5585 adults |
Patient’s diagnosis and type of surgery | End-stage chronic obstructive pulmonary disease (COPD), single vs bilateral lung transplants | End-stage chronic obstructive pulmonary disease (COPD), single vs bilateral lung transplants | End-stage chronic obstructive pulmonary disease (COPD), single vs bilateral lung transplants | Chronic obstructive pulmonary disease (COPD), single vs bilateral lung transplants | Chronic obstructive pulmonary disease (COPD), single vs bilateral lung transplants |
Study design | Systematic Review and Meta-Analysis | Retrospective study | Meta-analysis | Prospective multicenter cohort study | Retrospective cohort study |
Sample numbers | SLT (n = 6233) BLT (n = 4419) | SLT: 115 BLT: 71 | SLT ~ 20,728 BLT ~ 16,252 | SLT: 6269 BLT: 3754 | RSLT: 995 LSLT: 1010 BLT: 3580 |
Mean age | Not specified in the research | SLT: 65.3 ± 5.9 BLT: 63.2 ± 7.1 | ~ 45–65 | The average age was 65. Patients who undergo DLT tend to be younger, male patients. | RSLT: 63 (59–65) LSLT: 63 (59–66) BLT: 60 (55–64) |
Survival rate (with years) | BLT group was more favorable than the SLT group at 1 (OR = 1.29, 95% CI 1.16, 1.43, I2 = 0%), 5 (OR = 1.46, 95% CI 1.35, 1.58, I2 = 23%), 10 years (OR = 1.71, 95% CI 1.57, 1.87, I2 = 12%) | No difference in survival between the 2 age groups ≤ 65 versus > 65 years (P = 0.723) at 5 years post-transplant | At 3 years and 5 years, SLT had a lower rate ratio of survival than BLT (0.937, P = 0.041 and 0.775, P = 0.000, respectively) | The overall survival rates at 1, 3, and 5 years after transplantation: SLT 86.2%, 69.9%, 56.8% BLT 90.1%, 76.7%, 64.4% | The adjusted 5-year survival: RSLT 56.7% LSLT 50.9% BLT 57.8% |
Hazard ratio (with years) | 0.73, 95% CI 0.70, 0.76, I2 = 40%0.73, 95% CI 0.70, 0.76, I2 = 40% | Not specified in the research | No appreciable difference in the hazard ratio for survival (0.91, P = 0.07) | 0.819 (95% CI, 0.741–0.905) for DLT recipients compared with SLT recipients. | 0.88, 95% CI 0.77–1.02, p = 0.086 |
Outcomes | BLT appears to show more encouraging trends in survival rates for the treatment of end-stage COPD compared to SLT. | Exhibited non-inferior outcomes in SLT patients compared to BLT patients. | SLT had a greater risk of problems for patients with COPD than BLT. | Median post-transplant survival was 5.3 years in SLT versus 6.5 years in DLT (P < .001). DLT recipients have superior post-transplant survival. | They discovered that RSLT was linked to similar survival to DLT and greater survival than LSLT. |