Bilateral sequential single lung transplantation for pulmonary hypertension and Eisenmenger's syndrome

Background. Lung transplantation, with and without intracardiac repair for pulmonary hypertension (PH) and Eisenmenger's syndrome (EIS), has become an alternative transplant strategy to combined heart and lung transplantation (HLT). Methods. Thirty-five patients with PH or EIS underwent either bilateral seq uential single lung transplantation (BSSLT, group I, n = 13) or HLT (group II, n = 22). Another 74 patients, who underwent BSSLT for other indications , sewed as controls (group III). Immediate allograft function, early and me dium-term outcomes, lung function, and 2-year survival were compared betwee n the groups. Results. Comparisons between groups I and II showed no significant differen ce in any variables except percent predicted forced vital capacity. Immedia te allograft function was significantly inferior (p < 0.05) and the blood l oss was greater (p < 0.01) in group I when compared with those in group III . However, this resulted in no significant difference in early and medium-t erm outcomes, and 2-year survival between the 2 groups. Conclusions. BSSLT for PH and EIS can be performed as an alternative proced ure to HLT without an increase in early and medium-term morbidity and morta lity. Results are comparable with BSSLT performed for other indications. (C ) 2000 by The Society of Thoracic Surgeons.