COMPARISON OF OUTCOMES AFTER SINGLE AND BILATERAL LUNG TRANSPLANTATION FOR OBSTRUCTIVE LUNG-DISEASE

Background and Methods: To determine the long-term functional outcome for single versus bilateral lung transplant for nonseptic obstructive lung disease, we compared the results from 39 single and nine bilatera l lung transplant procedures. The nine bilateral lung transplants incl uded three en bloc double lung and six bilateral sequential lung trans plants. Results: Early deaths within 30 days of transplantation occurr ed in two of nine (22%) bilateral and 4 of 39 (10%) single lung transp lants (p = Not significant). Compared with pretransplant values, pulmo nary function as assessed by the spirometric indexes of the percent pr edicted forced vital capacity, forced expiratory volume in one second, forced expiratory volume in one second/forced vital capacity, and for ced expiratory flow at 25% and 75% of forced vital capacity improved s ignificantly up to at least 12 months after transplantation for both s ingle and bilateral lung transplant recipients. The degree of pulmonar y function improvement was better in single as compared with bilateral lung recipients. By 6 months after transplantation, all but one singl e and all bilateral lung recipients were in New York Heart Association class I or II (p = Not significant). One-year survival was significan tly better after single (77%) compared with after bilateral lung trans plantation (35%) (p < 0.05). Conclusions: These results suggest that s ingle lung transplantation is the procedure of choice for patients wit h nonseptic obstructive lung disease.