STATUS OF LUNG-TRANSPLANT RECIPIENTS SURVIVING BEYOND 5 YEARS

Background: Prolonged survival after lung transplantation is now commo nplace as a result of advances in surgical techniques and postoperativ e management protocols. Although 1- and 5-year functional and survival data after lung transplantation are well known, sparse information is available regarding functional status of recipients surviving beyond 5 years. Methods: The medical records and pulmonary function study res ults of lung transplant recipients who had survived at least 5 years a s of September 1995 were retrospectively reviewed. Results: Of the 76 transplantations performed between November 1983 and September 1990, 3 0 (39.5%) were double lung transplantations, and 46 (60.5%) were singl e lung transplantations. Thirty-one recipients were alive 5 years afte r transplantation (12 double lung transplantations, 19 single lung tra nsplantations). The 5-, 6-, and 7-year survival rates were 44%, 34%, a nd 29%, respectively. There was no association or difference in cytome galovirus status, sex, and blood group between those who died within 5 years and those who survived beyond 5 years. The median percent predi cted FEVs for single and double lung transplant recipients were as fol lows: 5 yrs-75%, 75%; 6 years-73%, 75%; 7 years-68%, 73%. The proporti on of recipients with bronchiolitis obliterans syndrome according to p ublished criteria was as follows: stage 0, 32%; stage I, 19%; stage II , 16%; and stage III, 19%. The functional status (i.e., active, workin g, disabled) 5 years after transplantation was as follows: active/work ing, 74%; active but not working, 13%; some limitation/independent, 10 %; and disabled, 3%. Conclusion: Bronchiolitis obliterans syndrome is a frequent occurrence in long-term survivors. Nevertheless, in spite o f this condition, most recipients have acceptable lung function, are a ctive, and are generally working.