TECHNIQUES AND RESULTS IN BILATERAL SEQUENTIAL SINGLE-LUNG TRANSPLANTATION

Lung transplantation continues to evolve as a therapeutic option for p atients with end-stage lung disease. Bilateral sequential single lung transplantation (BSSLTx) is a recent addition to the lung transplant s urgeon's armamentarium that incorporates the benefits of single lung t ransplantation in patients who require double lung replacement while a voiding the morbidity inherent in the en bloc double lung transplant p rocedure. Between November 1992 and October 1993, 17 recipients underw ent 18 bilateral BSSLTx procedures for a variety of indications. In 53 % of patients, the procedure was completed without the requirement for cardiopulmonary bypass. Telescoping of the bronchial anastomosis has proved satisfactory. Induction cytolytic therapy has not been utilized . Patients received methyl prednisolone from day 1 and as maintenance prednisolone therapy. Actuarial 1-year survival is 87%; 12 of the 15 s urvivors are in Functional Class I. BSSLTx is an evolving transplant o ption for patients who require double lung replacement. Definitive cli nical diffusion of the procedure will depend upon intermediate and lon g-term outcomes for specific recipient pathologies.