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

S Raju1, B J Heath, E T Warren

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

Annals of Surgery
|June 1, 1990
PubMed
Summary
This summary is machine-generated.

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This study reports on lung transplantation outcomes, noting a 33% operative mortality but highlighting successful management of late pneumonitis and rejection. Early infections were fatal, emphasizing the need for comprehensive pre-operative rehabilitation.

Area of Science:

  • Cardiothoracic Surgery
  • Transplantation Immunology

Background:

  • Resurgence in interest for single- and double-lung transplantation for end-stage lung disease.
  • Experience with nine lung transplant cases (six double, three single) reported.

Observation:

  • Lungs procured from up to 600 miles; donor hearts shared in 7/9 instances.
  • Operative mortality rate of 33% observed.
  • Early infections of donor origin were lethal; late transplant pneumonitis was generally well-tolerated.

Findings:

  • Three cases of significant tracheal suture line stenosis managed conservatively.
  • Bronchial artery implantation technique using donor aorta conduit described.
  • Rejection easily diagnosed and treated; complications included pleural fluid loss, space problems, and delayed chemoreceptor resetting causing hypercarbia.

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Implications:

  • Comprehensive pre-operative rehabilitation program is essential for successful lung transplantation.
  • Management strategies for complications like stenosis and rejection are crucial.
  • Donor lung procurement distance and organ sharing logistics impact transplant outcomes.