Related Experiment Videos
Single lung transplantation. Alternative indications and technique.
J H Calhoon1, F L Grover, W J Gibbons
1Department of Surgery, University of Texas Health Science Center, San Antonio.
Summary
Single lung transplantation is a viable option for critically ill patients, even those with pulmonary hypertension or chronic obstructive pulmonary disease. This study shows acceptable survival rates and no bronchial complications in 23 transplants.
Area of Science:
- Cardiology
- Pulmonology
- Transplant Surgery
Background:
- Single lung transplantation (SLT) was previously contraindicated for patients with pulmonary hypertension or severe chronic obstructive pulmonary disease (COPD).
- Advancements in surgical techniques and patient selection are crucial for improving outcomes in lung transplantation.
Purpose of the Study:
- To evaluate the feasibility and outcomes of single lung transplantation in a diverse group of critically ill patients.
- To assess the safety and efficacy of SLT in patients with conditions previously considered contraindications.
Main Methods:
- A retrospective review of 23 single lung transplants performed between March 1980 and April 1990.
- Detailed donor selection criteria and organ procurement techniques were employed.
- Standardized surgical procedures, including telescoping bronchial anastomosis, were utilized.
Main Results:
- Actuarial survival rates of 77.27% at 12 months and 72.73% at 24 months were achieved.
- No instances of bronchial dehiscence or stenosis were observed, despite immunosuppression protocols.
- Successful transplantation was performed in patients with primary pulmonary hypertension, secondary pulmonary hypertension, and COPD (including alpha 1-antitrypsin deficiency).
Conclusions:
- Single lung transplantation can be safely performed on a wide spectrum of critically ill patients, challenging previous contraindications.
- Meticulous preoperative and postoperative care are essential for successful single lung transplantation.
- SLT has evolved into a simpler procedure with acceptable mortality rates.