title: Lung transplantation after previous thoracic surgical procedures.
abstract: BACKGROUND
  This study examined results of lung transplantation after previous thoracic surgical procedures.
  
  
  METHODS
  Twenty percent of the 69 isolated lung transplantations performed at the University of North Carolina between January 1990 and June 1993 were in patients who had undergone a previous thoracic surgical procedure, and an additional 10% had undergone a previous chest tube placement.
  
  
  RESULTS
  No statistically significant increase in morbidity or mortality was observed between those having undergone a previous procedure or chest tube placement and all other patients. Specifically, the length of intubation, length of hospital stay, hospital mortality, or the number of patients who experienced major early complications was not significantly different between these groups. A statistically significant increase in the number of blood products used was observed in the patients with previous thoracic surgical procedures but not with patient having had previous chest tube placements. However, when the data were reanalyzed with respect to the use of cardiopulmonary bypass, those patients requiring bypass had a markedly poorer outcome that reached statistical significance in all of the parameters studied: hospital death, incidence of major complications, length of intubation, hospital stay, incidence of bleeding, and number of blood products used.
  
  
  CONCLUSIONS
  We conclude that although increased bleeding may be encountered, lung transplantation can be performed successfully in patients who have had previous thoracic surgical procedures without increased major morbidity or mortality; however, the use of cardiopulmonary bypass has been associated with significantly increased morbidity and mortality in our patient population.
authors.affiliation: Division of Cardiothoracic Surgery, University of North Carolina School of Medicine, Chapel Hill 27599-7065, USA.
authors.forename: F C
authors.initials: FC
authors.lastname: Detterbeck
authors.forename: T M
authors.initials: TM
authors.lastname: Egan
authors.forename: M R
authors.initials: MR
authors.lastname: Mill
mesh_terms: D001803:Blood Transfusion; D002315:Cardiopulmonary Bypass; D006801:Humans; D007442:Intubation, Intratracheal; D007902:Length of Stay; D008171:Lung Diseases / Q000601:surgery; D016040:Lung Transplantation / Q000401:mortality; D011183:Postoperative Complications; D012189:Retrospective Studies; D013903:Thoracic Surgery