We reviewed the impact of the presence of the native diseased contrala
teral lung on the outcome after single lung transplantation for emphys
ema. Twenty consecutive recipients of single lung transplants for emph
ysema were reviewed for complications related to the native lung, Five
patients (25 %) suffered major complications arising in the native lu
ng and resulting in serious morbidity and mortality. The timing of ons
et varied from 1 day to 43 months after transplantation. We conclude t
hat the susceptibility of the native lung to complications such as tho
se described in this report is an additional fact to be considered in
choosing the ideal transplant procedure for patients with obstructive
lung disease.