Lung transplantation is warranted for stable, ventilator-dependent recipients

Background. Lung transplantation for patients on ventilators is a controver sial use of scarce donor lungs. We have performed 500 lung transplants in 1 2 years and 21 of these have been in ventilator-dependent patients. Methods. A retrospective review of patient records and computerized databas e was performed. Living patients were contacted to confirm their health and functional status. Results. Patients included 13 men and 8 women with a mean age of 43 years. Sixteen patients were considered stable awaiting lung transplant, whereas 5 patients were unstable with acute graft failure after prior lung transplan tation. Stable patients had been ventilated for a mean of 57 +/- 46 days wh ereas unstable patients had been supported for 10 +/- 9 days. Half of the p atients required cardiopulmonary bypass support during the transplant, and there was no statistical difference in the frequency of CFB in stable and u nstable patients (p = 0.61). Three hospital deaths included 0 of 16 of the stable patients and 3 of 5 of the unstable patients (p = 0.01). Long-term a ctuarial survival was significantly better in stable versus unstable patien ts (p = 0.02), with 5-year survival 40% for stable patients and 0% for unst able patients. Conclusions. Lung transplantation can be successfully conducted in stable p atients who have become ventilator dependent after listing for transplantat ion. Acute retransplantation for early lung dysfunction is high risk and ha s produced poor long-term results. (Ann Thorac Surg 2000;70:1675-8) (C) 200 0 by The Society of Thoracic Surgeons.