One and One‐Half Year Experience with Unilateral and Bilateral Lung Transplantation

Lung transplantation has now become an established form of treatment for end‐stage pulmonary parenchymal and vascular diseases. Despite its wide acceptance, technical aspects are still in discussion. We report on the initiation of our own lung transplant program and the technical changes we have performed during our first 1 ½‐year experience. During that period of time, we have performed 26 lung transplantations (16 single lung [SLTX] and 10 bilateral lung transplantations [BLTX]). Three‐month survival for the whole group was 74% (69% for the SLTX group and 77% for the BLTX group). No instance of bronchial dehiscence was observed; however, there were eight cases of bronchial stenosis: six were managed by silicone stent insertion, one by bronchoplastic correction, and one by retransplantation. Changes in the technique of the bronchial anastomosis together with the addition of prednisone to the immediate postoperative immunosuppressive regime resulted in almost complete avoidance of these problems.

[1]  W. Gibbons,et al.  Single lung transplantation. Alternative indications and technique. , 1991, The Journal of thoracic and cardiovascular surgery.

[2]  G. Patterson,et al.  Comparison of outcomes of double and single lung transplantation for obstructive lung disease. The Toronto Lung Transplant Group. , 1991, The Journal of thoracic and cardiovascular surgery.

[3]  W. Klepetko,et al.  [Unilateral lung transplantation as an effective therapy in primary lung emphysema]. , 1991, Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen.

[4]  M. Kramer,et al.  Single lung transplantation: a new therapeutic option for patients with pulmonary hypertension. , 1991, Transplantation proceedings.

[5]  M. Pasque,et al.  Improved technique for bilateral lung transplantation: rationale and initial clinical experience. , 1990, The Annals of thoracic surgery.

[6]  H. Mal,et al.  Unilateral lung transplantation in end-stage pulmonary emphysema. , 1989, The American review of respiratory disease.

[7]  R. Ginsberg,et al.  Technique of successful clinical double-lung transplantation. , 1988, The Annals of thoracic surgery.

[8]  R. Ginsberg,et al.  Experience with single-lung transplantation for pulmonary fibrosis. The Toronto Lung Transplant Group. , 1988, JAMA.

[9]  R. Ginsberg,et al.  Technique of successful lung transplantation in humans. , 1987, The Journal of thoracic and cardiovascular surgery.

[10]  F. Veith,et al.  Revascularization of ischemic bronchial anastomoses by an intercostal pedicle flap. , 1985, The Journal of thoracic and cardiovascular surgery.

[11]  F. Veith,et al.  Influence of bronchial circulation and corticosteroid therapy on bronchial anastomotic healing. , 1984, The Journal of thoracic and cardiovascular surgery.

[12]  G. Patterson,et al.  Single-lung transplantation for pulmonary vascular disease. , 1991, Transplantation proceedings.

[13]  G. Patterson,et al.  Experimental and clinical double lung transplantation. , 1988, The Journal of thoracic and cardiovascular surgery.

[14]  Unilateral lung transplantation for pulmonary fibrosis. , 1986, The New England journal of medicine.