SINGLE-VERSUS DOUBLE-LUNG TRANSPLANTATION FOR PULMONARY-HYPERTENSION

Objectives: Uncertainty persists as to the best lung transplant operat ion for patients with pulmonary hypertension. To quantify short- and l ong-term outcomes after single- and double-lung transplantation for pu lmonary hypertension, we reviewed our clinical experience. Methods: A retrospective review of 58 lung transplants at a single institution be tween 1989 and 1996 was performed. Recipients had primary (n = 19) or secondary (n = 39) pulmonary hypertension. Results: Thirty-seven doubl e- and 21 single-lung transplants were performed. The groups were well matched with regard to preoperative characteristics. Cardiopulmonary bypass time was longer (151 vs 250 minutes) in the double-lung group. Excluding 10 patients surviving less than 30 days (6 double- and 4 sin gle-lung transplants), median duration of intubation (7.5 vs 10 days), length of stay in the intensive care unit (10 vs 16 days), and hospit al stay (32 vs 52 days) were not significantly different for the singl e- and double-lung groups, respectively. Actuarial survival was nearly identical, with 81% and 84% 1-month survivals for the single- and dou ble-lung groups, and identical 1-year (67%) and 4-year (57%) survivals for both groups. Late functional status was similar for recipients of single- and double-lung grafts, During the period of this study, 58 p atients with pulmonary hypertension died on our center's waiting list before coming to transplantation. Conclusions: These data suggest that lung transplant recipients with pulmonary hypertension have similar o utcomes after single- or double-lung transplantation. These results su pport cautious preferential application of single-lung transplantation for pulmonary hypertension.