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Ann Surg. 1990 Jun;211(6):681-91; discussion 691-3.

Single- and double-lung transplantation. Problems and possible solutions.

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  • 1Department of Surgery, University of Mississippi Medical Center, Jackson 39216-4505.

Abstract

There is a resurgence of interest in single- and double-lung transplantation for end-stage disease. An experience with six double-lung and three single-lung transplants is reported. The lungs were procured from a distance of up to 600 miles and the heart was shared with another team for transplantation in seven of nine instances. The operative mortality rate was 33%. Early transplant infections of donor origin were lethal. Late transplant pneumonitis was well tolerated and recovery was the rule. Three of nine cases had significant tracheal suture line stenosis and were managed conservatively. A technique of bronchial artery implantation using a conduit tailored from donor aorta is described. Transplant rejection was easily diagnosed and treated. Other notable complications included occasional massive pleural fluid loss, temporary space problem, and a delay in the 'resetting' of chemoreceptors resulting in moderate post-transplant hypercarbia accompanied by episodes in which the patient felt hypoxemic despite the maintenance of excellent levels of blood gases. A comprehensive rehabilitation program begun before operation is essential for success.

PMID:
2357131
PMCID:
PMC1358113
[PubMed - indexed for MEDLINE]
Free PMC Article
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