SINGLE-LUNG TRANSPLANTATION FOR PULMONARY-HYPERTENSION - SINGLE INSTITUTION EXPERIENCE IN 34 PATIENTS

Background The present study considered the uniformity and durability of the cardiopulmonary response to single lung transplantation in pati ents with severe pulmonary hypertension, as well as its effect on leng th and quality of survival. Methods and Results Thirty-four patients w ith pulmonary hypertension underwent evaluation, single lung transplan tation, and follow-up assessment between November 1, 1989, and June 1, 1994. Operative survival for the entire group of patients was reasona ble, with 98% (31 of 34 patients) surviving and being discharged from the hospital following transplantation. The actuarial survival for the se 34 patients at 1-, 2-, and 3-year follow-up was 78%, 66%: and 61%, respectively. In the subgroup of 24 patients with primary pulmonary hy pertension (PPH), 96% (23 of 24) were successfully discharged from the hospital after transplantation. The actuarial survival for this isola ted PPH subgroup at 1-, 2-, and 3-year follow-up was 87%, 76%, and 68% , respectively. The uniform, early posttransplant normalization of pul monary vascular resistance and right ventricular ejection fraction app ears to persist throughout the 4-year follow-up period. Despite a high prevalence of bronchiolitis obliterans, the majority of survivors rem ain in New York Heart Association functional class I or II and are emp loyed. Conclusions Single lung transplantation can be performed in pat ients with end-stage pulmonary vascular disease with reasonable expect ations for a relatively low operative mortality; immediate, complete, and durable amelioration of pulmonary hypertension and right ventricul ar failure; and optimal use of limited donor organ supply.