Evidence map›Paper›PMID 40859906›Full record

ArticleESC heart failure2025

Four decades of heart-lung transplantation: Milestones and outcomes in advanced cardiorespiratory failure.

L Lily Rosenthal, Anna Maria Mühlbauer, Carola Grinninger, Nikolaus A Haas, Heinrich Netz, Robert Dalla Pozza, Jürgen Hörer, Sebastian Michel, R Schramm, D Graetz and 1 more

Abstract read
In one paragraph

Article in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

L Lily RosenthalDivision of Paediatric and Congenital Heart Surgery, LMU University Hospital Munich, Munich, Germany.ORCID https://orcid.org/0000-0001-9479-8655
Anna Maria MühlbauerDivision of Paediatric and Congenital Heart Surgery, LMU University Hospital Munich, Munich, Germany.
Carola GrinningerDepartment of Cardiac Surgery, LMU University Hospital Munich, Munich, Germany.
Nikolaus A HaasDivision of Paediatric Cardiology and Intensive Care, LMU University Hospital Munich, Munich, Germany.
Heinrich NetzDivision of Paediatric Cardiology and Intensive Care, LMU University Hospital Munich, Munich, Germany.
Robert Dalla PozzaDivision of Paediatric Cardiology and Intensive Care, LMU University Hospital Munich, Munich, Germany.
Jürgen HörerDivision of Paediatric and Congenital Heart Surgery, LMU University Hospital Munich, Munich, Germany.
Sebastian MichelDivision of Paediatric and Congenital Heart Surgery, LMU University Hospital Munich, Munich, Germany.
R SchrammClinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Centre North Rhine-Westphalia (HDZ NRW), Bad Oeynhausen, Germany.
D GraetzDepartment of Cardiac Surgery, LMU University Hospital Munich, Munich, Germany.
Christian HaglDepartment of Cardiac Surgery, LMU University Hospital Munich, Munich, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsHeart-lung transplantation (HLTx) remains a life-saving intervention for patients with end-stage cardiopulmonary failure. We retrospectively analysed long-term HLTx outcomes at our centre to assess survival trends and evaluate the impact of evolving immunosuppressive, surgical and perioperative strategies. METHODS AND

resultsThis single-centre retrospective cohort study included 80 patients who underwent HLTx between 1983-1995 (Era 1) and 1996-2010 (Era 2), with follow-up through June 2024. All patients had severe cardiorespiratory failure. The primary endpoint was all-cause mortality. Secondary endpoints included early and late post-transplant outcomes. Overall survival at 1, 5 and 10 years post-transplant was 60 ± 6%, 46 ± 6% and 35 ± 6%, respectively. Survival improved significantly between Era 1 (46 ± 10%, 18 ± 9% and 9 ± 6%) and Era 2 (66 ± 7%, 5 ± 7% and 45 ± 7%) (P < 0.001), correlating with advancements in immunosuppression, organ preservation and perioperative care. Univariable risk factors for increased mortality included Euro Collins versus Perfadex lung preservation (P < 0.001), University of Wisconsin (UW2) versus Histidine-Tryptophan-Ketoglutarate (HTK) solution cardioplegia (P < 0.001), and Epstein-Barr virus infection (P = 0.036). Heart failure: OR 4.557 (95% CI: 1.057-19.648, P = 0.042) and gastrointestinal bleeding: OR 2.739 (95% CI: 1.310-5.726, P = 0.016) were identified as risks for mortality. These factors remained significant in multivariable analysis.

conclusionsHLTx outcomes at our centre are consistent with international benchmarks. Survival has improved in Era 2, likely due to individualised immunosuppressive regimens, novel organ preservation techniques and enhanced surveillance. These results support ongoing optimisation of multidisciplinary care for complex cardiopulmonary failure.

Indexed as

Heart FailureHeart-Lung TransplantationRespiratory InsufficiencyAdultFemaleFollow-Up StudiesHumansMaleMiddle AgedRetrospective StudiesSurvival RateTime FactorsTreatment OutcomeBronchiolitis obliterans syndromeCongenital heart diseaseEnd‐stage cardiopulmonary failureGraft preservationHeart–lung transplantationImmunosuppressionPulmonary hypertension

Identifiers

PMID40859906
PMCPMC12719830

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.