Unilateral lung transplantation in end-stage pulmonary emphysema.
Patients with end-stage pulmonary emphysema are usually proposed for either heart-lung or double-lung transplantation. The single-lung transplantation is reversed for patients with pulmonary fibrosis. Patients with emphysema are thought to be unsuitable for single-lung transplantation because of the ventilation-perfusion imbalance that is supposed to occur, the ventilation being preferentially distributed to the native lung when the perfusion is distributed to the transplanted lung. We now report a preliminary success with single-lung transplantation in two consecutive patients with end-stage pulmonary emphysema. Despite the persistence after transplantation of an obstructive syndrome, the clinical status was good, the blood gases were markedly improved, and ventilation-perfusion imbalance did not occur on lung scans. After discharge from the hospital, the patients could return to an almost normal life. Thus, our data support the feasibility of single-lung transplantation in patients with end-stage pulmonary emphysema, and we consider that single-lung transplantation could be the optimal form of lung transplantation in these patients.
Mal
H
H
Service de Pneumologie et Réanimation, Hôpital Beaujon, Clichy, France.
Andreassian
B
B
Pamela
F
F
Duchatelle
J P
JP
Rondeau
E
E
Dubois
F
F
Baldeyrou
P
P
Kitzis
M
M
Sleiman
C
C
Pariente
R
R
D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D011877:Radionuclide Imaging