EARLY EXPERIENCE WITH SINGLE-LUNG TRANSPLANTATION FOR EMPHYSEMA WITH SIMULTANEOUS VOLUME REDUCTION OF THE CONTRALATERAL LUNG

objective: Single lung transplantation (SLT) for emphysema has given s atisfactory. long term results in most patients. The mediastinal shift caused by the native emphysematous lung may require further surgical intervention in selected cases. Methods: We report a technique of simu ltaneous SLT and volume reduction of the contralateral lung in 4 patie nts with end stage respiratory failure secondary to emphysema. There w ere two right and two left SLT, performed in two male and two female p atients. Their mean age was 52.2 (S.D. 4) years (range between 41 and 57 years) and the ischaemia time averaged 255.6 (S.D. 16) min (range b etween 225 and 255 min). The volume of the contralateral lung was redu ced using staples. The stapled lines were buttressed by the donors per icardium. Results: Their were no operative related complications apart from air leak which settled spontaneously within 5 days postoperative ly. The pre-operative FEVI showed a mean value of 0.57 (S.D. 0.1) L (1 7.2% (S.D. 2) of the predicted) which improved to 1.79 (S.D. 0.4) L (5 8.2% (S.D. 8) of the predicted) at last follow up (P < 0.005). Radiolo gical examinations at 1 year showed central mediastinum with satisfact ory respiratory function, Conclusion: We conclude that;his technique c an be performed for patients with emphysema without increase in the op erative morbidity and with good early respiratory function. Further fo llow up is required to assess the long term results of this procedure. (C) 1997 Elsevier Science B.V.