title: Technique of successful clinical double-lung transplantation.
abstract: Lung transplantation has become a successful method in the therapy for end-stage pulmonary disease. While single-lung transplantation provides benefit to patients with pulmonary fibrosis, bilateral lung transplants are required for septic or emphysematous lung disease. We describe the technique employed in 6 patients to transplant en bloc both lungs with the recipient heart left in place. The lungs are connected by a left atrial cuff, main pulmonary artery, and trachea. The completed implantation has a tracheal anastomosis securely wrapped in omentum, a left atrial anastomosis posterior to the heart, and a pulmonary artery anastomosis anteriorly. Airway ischemia resulted in the death of 1 patient. This procedure allows complete excision of all diseased pulmonary tissue, retention of the recipient's own heart, and separate excision of the donor heart for use in another recipient, thereby markedly increasing the supply of donor lungs for transplantation.
authors.affiliation: Department of Surgery, University of Toronto, Ont, Canada.
authors.forename: G A
authors.initials: GA
authors.lastname: Patterson
authors.forename: J D
authors.initials: JD
authors.lastname: Cooper
authors.forename: B
authors.initials: B
authors.lastname: Goldman
authors.forename: R D
authors.initials: RD
authors.lastname: Weisel
authors.forename: F G
authors.initials: FG
authors.lastname: Pearson
authors.forename: P F
authors.initials: PF
authors.lastname: Waters
authors.forename: T R
authors.initials: TR
authors.lastname: Todd
authors.forename: H
authors.initials: H
authors.lastname: Scully
authors.forename: M
authors.initials: M
authors.lastname: Goldberg
authors.forename: R J
authors.initials: RJ
authors.lastname: Ginsberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D005260:Female; D006324:Heart Arrest, Induced; D006325:Heart Atria / Q000601:surgery; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008171:Lung Diseases / Q000601:surgery*; D016040:Lung Transplantation; D008297:Male; D009852:Omentum / Q000601:surgery; D011651:Pulmonary Artery / Q000601:surgery; D011656:Pulmonary Emphysema / Q000601:surgery*; D014132:Trachea / Q000601:surgery
chemical_list: D007166:Immunosuppressive Agents