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Experience with lung transplantation.

A Haverich1

  • 1Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Germany. haverich@thg.mh-hannover.de

The Annals of Thoracic Surgery
|April 10, 1999
PubMed
Summary
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Lung transplantation offers acceptable long-term survival, but bronchiolitis obliterans syndrome remains a significant challenge. Despite expanded indications, overall survival rates have not improved over ten years.

Area of Science:

  • Cardiothoracic Surgery
  • Pulmonary Medicine
  • Transplant Immunology

Background:

  • Established a lung transplantation program in 1987, building on 5 years of heart transplantation experience.
  • Conducted a comprehensive 10-year review of patient data and program outcomes.
  • Initiated based on extensive prior experience in heart transplantation and animal research.

Discussion:

  • Analyzed 283 lung transplant procedures (heart-lung, single-lung, bilateral lung) and 24 retransplantations.
  • Evaluated trends in indications, surgical procedures, donor criteria, and survival across diverse patient subgroups.
  • Examined long-term follow-up data to assess outcomes and identify challenges.

Key Insights:

  • Overall 5-year survival rate reached 63% across all lung transplant types.

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  • Patients with cystic fibrosis, emphysema, pulmonary fibrosis, and secondary pulmonary hypertension demonstrated similar survival.
  • Primary pulmonary hypertension was linked to poorer long-term survival outcomes.

    • Outlook:

    • Bronchiolitis obliterans syndrome (BOS) affects approximately 15% of patients annually, representing a major hurdle for long-term survival.
    • While acceptable results are achievable, expanded indications have not yielded overall survival benefits in the studied decade.
    • Continued research is needed to overcome BOS and improve long-term lung transplant outcomes.