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Unilateral volume reduction after single-lung transplantation for emphysema
T J Kroshus1, R M Bolman, V R Kshettry
1Division of Cardiovascular and Thoracic Surgery, University of Minnesota, Minneapolis, USA.
The Annals of Thoracic Surgery
|August 1, 1996
Summary
Single-lung transplantation for emphysema can lead to native lung hyperinflation. Volume reduction surgery safely relieves symptoms and improves exercise tolerance in these patients.
Area of Science:
- Pulmonary Medicine
- Thoracic Surgery
- Transplantation Surgery
Background:
- Single-lung transplantation is a standard treatment for end-stage emphysema.
- Native lung hyperinflation can complicate single-lung transplantation, compressing the graft.
- Volume reduction surgery may alleviate post-transplant complications.
Observation:
- Three patients developed native lung hyperexpansion with mediastinal shift post-transplant.
- This complication occurred 12, 17, and 42 months after single-lung transplantation.
- All three patients underwent successful unilateral volume reduction procedures.
Findings:
- Volume reduction significantly improved chest radiographs and relieved dyspnea.
- Patients experienced improved exercise tolerance after the procedure.
- Pulmonary function tests showed improvement in one patient.
Implications:
- Symptomatic native lung hyperexpansion is a potential complication after single-lung transplantation for COPD.
- Unilateral volume reduction is a safe and effective treatment for this post-transplant complication.
- This procedure can improve quality of life and respiratory function in select transplant recipients.