LUNG TRANSPLANTATION FOR EMPHYSEMA

This study is a retrospective analysis of clinical parameters and pulm onary function in seven male patients receiving lung transplantation b etween June 1993 and February 1996 as a treatment for pulmonary emphys ema. The patients were suffering severe airway obstruction, functional class III-IV, and were dependent on home therapy with oxygen. Their m ean age was 54.9 years (+/- 5.4 years) and their mean waiting list tim e was 266 +/- 158 days. Transplantation was sequential bilateral (TPb) in one case and unilateral (Tpu) in the remaining 6. A triple inmunos uprresant protocol was employed (Cyclosporina A - Azathioprin-Predniso ne) and bronchoscopy was performed on a regular basis and on evidence of infection or rejection. The patient who received the bilateral tran splant 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 transpla ntation due to hypertensive pneu-mothorax of the native lung. All pati ents presented acute rejection between 10 and 86 days after transplant ation, responding well to treatment with Methylprednisone or increased immunosuppression. All patients receiving unilateral transplantation showed marked improvement in functional class, gas exchange, and pulmo nary function.