[Single-lung transplant and primary graft failure].
OBJECTIVE
To quantify primary graft failure (PGF) and its impact on perioperative and early mortality in single-lung transplant (SLT).


METHODS
We analyzed 35 SLT procedures performed using similar techniques. PGF was defined as a PaO2/FiO2 coefficient lower than 200 mmHg during the first 72 hours or ventilation assistance lasting longer than 5 days attributable to primary lung dysfunction. We defined perioperative mortality as occurring within 30 days of surgery and early mortality within 90 days.


RESULTS
Twenty-five men and 10 women received lungs, 22 for pulmonary fibrosis and 13 for emphysema; the mean age was 53.26 10.77 years. Twenty right SLTs were performed and 15 left SLTs. Twenty-nine donors were men and 6 were women, with a mean age of 29.31 12.33 years. Twenty-six died from cranial trauma, 8 from stroke and 1 from a brain tumor. The mean time of intubation was 1.69 1.35 days. The mean PaO2 was 470.71 70.82 mmHg. The mean time of ischemia was 201.77 62.64 minutes. Four patients (11.42%) developed PGF and 3 died during the perioperative period. Two additional patients died within the early postoperative period. Survival was 91.4% at one month and 85.5% at three months. The cause of donor death was the only variable that influenced the development of PGF.


CONCLUSIONS
We observed a low incidence of PGF and of perioperative and early mortality, with one and three month survival rates similar to those reported internationally.
Padilla
J
J
Servicio de Cirugía Torácica, Hospital Universitario La Fe, Valencia, Spain. jpadialla@comv.es
Calvo
V
V
Pastor
J
J
Blasco
E
E
París
F
F
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D016040:Lung Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D015427:Reperfusion Injury / Q000453:epidemiology / Q000209:etiology*