Lung transplantation: a decade of experience.
BACKGROUND
Over the past 3 decades, the field of lung transplantation has been refined. However, many barriers exist that limit long-term success. The purpose of this study was to review a single institution's long-term experience with single and double lung transplantation and to assess the effect of different immunosuppressive therapies on outcomes.


METHODS
Lung transplant recipients, both single and double, were reviewed, retrospectively. Patients were divided into five groups: group I, all lung transplants (n = 127); group II, single lung transplants (n = 73); group III, double lung transplants (n = 54); group IV, OKT3 induction therapy recipients (n = 27); and group V, RATG induction therapy recipients (n = 100). Rates of survival, rejection, bronchiolitis obliterans syndrome (BOS) and infection were analyzed at 1, 3, and 5 years.


RESULTS
There were no significant differences in survival, acute rejection rate, freedom from BOS, nor infection between single and double lung transplant recipients. Induction therapy with RATG (group V) was associated with significantly improved survival and freedom from acute rejection, BOS, and infection when compared to OKT3 induction therapy (group IV).


CONCLUSIONS
An earlier impression that RATG is superior to OKT3 induction therapy has borne true in terms of overall survival and incidence of BOS, acute rejection and infection rates. Lung transplantation, using RATG induction therapy, remains an important modality for end-stage pulmonary disease.
Moffatt
Susan D
SD
Department of Cardiothoracic Surgery, Stanford University, Stanford, CA 94305, USA.
Demers
Philippe
P
Robbins
Robert C
RC
Doyle
Ramona
R
Wienacker
Ann
A
Henig
Noreen
N
Theodore
James
J
Reitz
Bruce A
BA
Whyte
Richard I
RI
D000328:Adult; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D001989:Bronchiolitis Obliterans / Q000453:epidemiology / Q000209:etiology; D003550:Cystic Fibrosis / Q000453:epidemiology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016040:Lung Transplantation; D008297:Male; D016853:Muromonab-CD3 / Q000627:therapeutic use; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000628:therapy; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016853:Muromonab-CD3