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Lung transplantation for emphysema

G A Patterson¹, J D Cooper

¹Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.

Chest Surgery Clinics of North America

|November 1, 1995

Summary

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Lung transplantation offers acceptable results for emphysema patients but carries significant risks from immunosuppression and long-term complications. It should be reserved for ideal candidates with no alternative treatments.

Area of Science:

Pulmonary Medicine
Transplant Surgery
Immunology

Background:

Lung transplantation is a viable treatment for emphysema caused by chronic obstructive pulmonary disease (COPD) or alpha-1-antitrypsin deficiency.
Established centers report low operative mortality and acceptable functional outcomes post-transplant.

Purpose of the Study:

To evaluate the overall efficacy and risks associated with lung transplantation.
To determine the long-term survival rates and identify key complications.

Main Methods:

Review of outcomes in patients undergoing lung transplantation for emphysema.
Analysis of morbidity related to triple drug immunosuppression regimens.
Assessment of annual mortality rates from specific complications like obliterative bronchiolitis.

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Main Results:

Lung transplantation demonstrates low operative mortality and acceptable functional results in experienced centers.
Significant morbidity is linked to triple drug immunosuppression protocols.
A constant annual death rate leads to a 50% 5-year survival rate.

Conclusions:

Lung transplantation is a critical option for emphysema patients lacking alternatives.
The procedure's benefits must be weighed against substantial immunosuppression-related morbidity and long-term survival limitations.
Careful selection of ideal candidates is paramount for optimizing outcomes.