EARLY AND LONG-TERM FUNCTIONAL OUTCOMES IN UNILATERAL, BILATERAL, ANDLIVING-RELATED TRANSPLANT RECIPIENTS

Lung transplantation offers the possibility of improved quality of lif e and survival in patients with severe pulmonary and pulmonary vascula r disease. Since the first human lung allotransplantation in 1963, sur vival has moved from hours or days into the present era of long-term ( years) survival in many recipients. Measurement of outcome has now ext ended to measurement of exercise capacity and quality of life. A subst antial improvement in quality of life is seen; however, exercise capac ity remains moderately impaired in spite of the return (in many) of ne ar normal cardiopulmonary function, suggesting peripheral limitation t o exercise. Recently, fiber type changes and abnormal oxidative metabo lism have been shown in the skeletal muscle of stable lung transplant recipients. This suggests a persistence of a pretansplant skeletal mus cle injury and/or the effects of post-transplant immunosuppression (pa rticularly Cyclosporin A and corticosteroids).