[Lung transplantation in emphysema]

This study is a retrospective analysis of clinical parameters and pulmonary function in seven male patients receiving lung transplantation between June 1993 and February 1996 as a treatment for pulmonary emphysema. The patients were suffering severe airway obstruction, functional class III-IV, and were dependent on home therapy with oxygen. Their mean age was 54.9 years (+/- 5.4 years) and their mean waiting list time was 266 +/- 158 days. Transplantation was sequential bilateral (TPb) in one case and unilateral (Tpu) in the remaining 6. A triple inmunosuppresant protocol was employed (Cyclosporina A--Azathioprin-Prednisone) and bronchoscopy was performed on a regular basis and on evidence of infection or rejection. The patient who received the bilateral transplant died 76 days later due to necrohemorrhagic pancreatitis. The 6 unilateral transplant patients were discharged in good condition 31.3 +/- 9.0 days after transplant. One patient died 69 days after transplantation due to hypertensive pneu-mothorax of the native lung. All patients presented acute rejection between 10 and 86 days after transplantation, responding well to treatment with Methylprednisone or increased immunosuppression. All patients receiving unilateral transplantation showed marked improvement in functional class, gas exchange, and pulmonary function.