Impact of graft ischemic time on outcomes after bilateral sequential single-lung transplantation

Background. Graft ischemic time (GIT) is a potential limiting factor in lun g transplantation. Methods. Seventy-four patients who underwent bilateral sequential single-lu ng transplantation were divided into three groups: group I, GIT less than 5 hours (n = 20); group II, GIT between 5 and 8 hours (n = 39); and group II I, GIT more than 8 hours (n = 15). We compared early allograft function (ra tio of arterial oxygen tension to inspired oxygen fraction and alveolar-art erial oxygen gradient), blood loss, the need for tracheostomy, the duration of ventilation, intensive care unit stay, and hospital stay. We also compa red prevalences of acute and chronic rejection, airway complications, lung function test, and 2-year survival. Results. Early allograft function in group III was significantly worse than those in groups I and II. However, there was no significant difference in any other variables of early and medium-term outcomes among the three group s. No significant correlation was detected between GIT and duration of inte nsive care unit stay or hospital stay. Conclusions, The limitation of acceptable GIT could be extended from the tr aditionally approved 4 to 5 hours, to 5 to 8 hours or even longer. (C) 1999 by The Society of Thoracic Surgeons.