Outcomes of Lung Transplantation Surgery Performed at Night

This retrospective cohort study from the Netherlands investigated the impact of surgical timing on the outcomes of bilateral lung transplantation and evaluated the utility of deferring surgery to daytime hours. Analyzing 227 adults, the authors compared a night cohort (≥1 hour of surgery between 02:00 and 06:00; n=85) against a day cohort (n=142). Results demonstrated no statistically significant differences in intensive care unit length of stay, one-year survival, three-year bronchiolitis obliterans syndrome-free survival, time to extubation, operative duration, ischemic and implant times, blood loss, and wound complications. The authors attribute these similar outcomes to their institution’s implementation of dedicated, shift-based multidisciplinary teams, which mitigates the human fatigue factors typically associated with after-hours surgical morbidity. The authors thus conclude that nocturnal lung transplantation remains safe and efficacious, empowering centers to dictate operative timing based on logistical optimization rather than circadian outcome concerns.