EARLY EXPERIENCE IN LUNG TRANSPLANTATION

Lung transplantation is becoming an acceptable mode of therapy worldwi de for end-stage lung disease. We present our initial experience with the first 10 consecutive lung transplant patients at Hadassah Universi ty Hospital. There were 5 males and 5 females with an age range of 27 to 59 years. Eight patients underwent single lung transplantation, one patient had double lung transplantation and one had heart-lung transp lantation Indications were: pulmonary fibrosis in 4, emphysema in 4, c ystic fibrosis in 1, and cystic bronchiectasis in 1. Two patients had primary graft failure (1 death). Nine patients had a serious infection after transplantation (1 death). Four patients developed airway compl ications including dehiscence of bronchial anastomosis (1 death), bron chial stenosis requiring placement of a stent in 2 patients, and pneum othorax in 1 patient. One patient required tracheostomy. One patient d ied of massive brain infarction secondary to pulmonary, venous thrombo sis and embolization. Six patients are intermediate-term survivors, wi th a follow-up period of 4-24 months. Four of them had at least one ep isode of rejection each. In all survivors pulmonary functions and qual ity of life improved and they do not need supplemental oxygen. We conc lude that lung transplantation is a viable option for end-stage lung d isease. Better selection of patients and perhaps improved immunosuppre ssion agents will further improve outcome in lung transplantation. Sho rtage of donor supply is currently the limiting factor in successful l ung transplantation in israel.