Double-lung transplantation for cystic fibrosis. The Cystic Fibrosis Transplant Study Group.
One hundred twenty cystic fibrosis patients were accepted for transplantation. Twenty-five patients underwent double-lung transplantation. Twenty-five patients died awaiting transplantation (20.6%). There were 13 female and 12 male patients. Their mean age was 28 years (range, 7 to 34 years), and mean percentage ideal body weight was 76% (range, 58.5% to 91.9%). Most patients were hypoxic and hypercarbic. Two patients underwent tracheal anastomosis, 15 had en bloc bronchial anastomoses, and 8 had sequential single-lung transplants. Operative mortality was 16%; all deaths were related to bleeding from extensive adhesions. Actuarial survival at 1 year was 64%. Rejection and infection were frequent during the first month and decreased thereafter. Airway complications occurred in 5 patients but were amenable to laser therapy and stenting. We conclude that double-lung transplantation is an acceptable modality for the treatment of cystic fibrosis patients with end-stage lung disease. It may be a better alternative to heart-lung transplantation considering the paucity of thoracic organ donors.
Shennib
H
H
Thoracic Surgery Departments, Ste-Marguerite Hospital, Marseille, France.
Noirclerc
M
M
Ernst
P
P
Metras
D
D
Mulder
D S
DS
Giudicelli
R
R
Lebel
F
F
Dumon
J F
JF
D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D002648:Child; D003550:Cystic Fibrosis / Q000601:surgery*; D005260:Female; D006084:Graft Rejection; D006801:Humans; D008172:Lung Diseases, Fungal / Q000188:drug therapy / Q000382:microbiology; D016040:Lung Transplantation / Q000379:methods* / Q000401:mortality; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies