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Related Experiment Videos

Single or bilateral lung transplantation for emphysema?

R S Sundaresan1, Y Shiraishi, E P Trulock

  • 1Department of Surgery, Washington University School of Medicine/Barnes Hospital, St. Louis, Mo., USA.

The Journal of Thoracic and Cardiovascular Surgery
|December 1, 1996
PubMed
Summary

Bilateral lung transplantation offers superior functional improvements and potentially better long-term survival for emphysema patients compared to single lung transplantation. Both procedures provide durable results, but bilateral transplants yield greater benefits in spirometry, oxygenation, and exercise tolerance.

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Area of Science:

  • Pulmonology
  • Thoracic Surgery
  • Transplantation Medicine

Background:

  • Single lung transplantation is common for emphysema, but bilateral lung transplantation is favored by some centers due to controversy.
  • Single lung transplantation is typically reserved for older or smaller patients.

Purpose of the Study:

  • To compare outcomes between single and bilateral lung transplantation for emphysema.
  • To define the optimal role for single versus bilateral lung transplantation in emphysema management.

Main Methods:

  • Retrospective analysis of 119 lung transplantations for emphysema (50 single, 69 bilateral).
  • Comparison of baseline characteristics, post-operative outcomes, and long-term survival between the two groups.

Main Results:

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  • No significant differences in 90-day mortality, ventilation duration, or ICU/hospital stay.
  • Both groups showed sustained improvements in pulmonary function and exercise tolerance within 3 months.
  • Bilateral lung transplantation recipients demonstrated significantly better improvements in spirometry, oxygenation, and exercise tolerance from 6 months onward.
  • Obliterative bronchiolitis prevalence was similar; bilateral transplants showed a trend toward better late survival (5-year actuarial survival: 53% vs. 41%).

Conclusions:

  • Both single and bilateral lung transplantation are effective for emphysema, yielding durable results.
  • Bilateral lung transplantation offers superior functional improvements (spirometry, oxygenation, exercise tolerance) and possibly better late survival without increased operative risk.
  • Enhanced pulmonary reserve post-bilateral transplantation may explain superior functional and survival outcomes.