To evaluate the safety of bilateral lung transplantation and its relative risk factors at short-term follow-up.

The clinical data of 30 bilateral lung transplantation recipients who got transplantation in China Japan Friendship Hospital from April 2017 to June 2018 were retrospectively analysed. The recipients were divided into 2 groups according to the survival condition at 90 days after transplantation, 22 recipients were grouped into survival group, and the rest were grouped into death group. Indexes including oxygenation index, age and body index of recipient, difference of body surface area between donor and recipient, cold ischemia duration of donor lungs, operation duration, intraoperative blood loss and infusion between the two groups were compared with independent t test. The volume of blood transfusion and urinary amount during transplantation were compared with Wilcoxon rank sum test. Infectious status of donor, and gender, primary disease, preoperative infectious status, utilization of respirator and extracorporeal membrane oxygenation (ECMO) before operation, sequence of transplantation, transfusion and utilization of ECMO during operation, and anastomotic fistula after operation between the 2 groups were compared with chi-square test. P<0.05 means statistically significant.

Among 30 donors, 19 cases showed positive etiology preoperatively, including 14 cases of single infection and 5 cases of mixed infection. 16 recipients showed positive etiology preoperatively, including 12 cases of single infection and 4 cases of mixed infection. Left lung transplant were performed preferentially in 11 cases, whereas right lung transplant were performed preferentially in 19 cases. Eight recipients died [26.7% (8/30)] during their postoperative 90 days, 4 recipients died of toxic shock. The other 4 recipients died of broncho-bronchus anastomosis fistula, massive hemoptysis, circulation function failure and active bleeding, respectively. The result of the risk factors influencing the short-term prognosis of recipients showed that the blood transfusion volume of survival group and death group were 900 mL (0~6 450 mL) and 25 mL (0~1 450 mL) respectively, which had statistical significance (z=-2.524, P<0.05).

Perioperative mortality of bilateral lung transplant was acceptable. The blood transfusion volume during transplantation could influence the survival rate of recipients at short-term follow-up.