Long-term results of lung transplantation for emphysema.
BACKGROUND
We sought to assess the differences between lung transplantation (LT) to treat emphysema, versus other pulmonary diseases.


METHODS
This retrospective review of lung transplantations (LTs) performed from October 1993 to September 2003, included donor and recipient demographic data, pulmonary function, oxygenation, postoperative complications, incidence of rejection and pneumonia, and survival.


RESULTS
Of 159 LTs performed the 39 transplanted to treat emphysema (24.4%), were in 33 men and 6 women of age 50.9 +/- 8.7 years (men, 25 to 65 years). There were differences between the emphysema vs other groups in terms of age (P < .001), gender (P = .001), need for bypass (P = .004), and immediate posttransplantation oxygenation index (P = .001). Perioperative mortality tended to be lower among patients with emphysema (2.7% vs 10.8%; P = .131). The incidences of complications and acute rejections was similar. Forced vital capacity, forced expiratory volume in 1 second, arterial oxygen tension, and arterial carbon dioxide tension improved significantly post-Tx. Actuarial survivals were 82%, 68%, and 63%, respectively, at 1, 3, and 7 years posttransplantation for emphysema patients vs 60%, 53%, and 42%, respectively, at 1, 3, and 7 years posttransplantation for non-emphysema patients (P = .049).


CONCLUSIONS
Lung transplantation in patients with emphysema offers good long-term survival, with significant improvement in functional status and low morbidity. The older age of emphysema patients was not associated with a higher incidence of postoperative complications.
Algar
F J
FJ
Department of Thoracic Surgery, Lung Transplantation Unit, University Hospital Reina Sofia, Córdoba, Spain. kindelan@arrakis.es
Alvarez
A
A
Lama
R
R
Santos
F
F
Baamonde
C
C
Cerezo
F
F
Salvatierra
A
A
D000328:Adult; D002423:Cause of Death; D016009:Chi-Square Distribution; D004646:Emphysema / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016040:Lung Transplantation / Q000379:methods / Q000401:mortality / Q000502:physiology*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors