Is Combined Lung-Liver Transplantation Justified? 30-Year Review of UNOS Database

Purpose Combined lung-liver transplantation (LLT) significantly increases the complexity of lung transplantation (LT) due to operative, donor, and recipient factors. The ethics of allocating dual organs to single recipients remains controversial. There is limited information on the short and long term survival of LLT recipients. Methods Review of UNOS database was performed from years 1987-2018. Univariate and multivariate analyses were performed adjusting for LLT, age, sex, ischemic time, need for dialysis, and HLA mismatch. Results 30, 110 LTs and 74 LLTs were performed. Median follow up was 42 +/− 44 months for LLT and 51+/−50 months for LT. LLT recipients were younger (40.0 ± 15.1 vs. 54.2 ± 12.9 years, p Conclusion Despite higher recipient acuity, in appropriately selected patients, short and long term survival of LLT is comparable to isolated LT.