[The operative technique selection of lung transplantation for end-stage emphysema].
OBJECTIVE
To investigate the operation of lung transplantation for end-stage emphysema.


METHODS
From September 2002 to February 2005, 9 patients with chronic obstructive pulmonary disease (COPD) underwent lung transplantation. The types of surgery included single lung transplantation in 2 patients, lung transplantation with asynchronous contralateral lung volume reduction (one week later) in 1, single lung transplantation with synchronized contralateral lung volume reduction in 4, and bilateral sequential lung transplantation without cardiopulmonary bypass in 2.


RESULTS
The volume of chest drainage was more than 2000 ml at the first postoperative day in 2 patients, one was reoperated for hemostasis and another was successfully responded to conservative therapy. The ventilation time was ranged from 3 to 22 days postoperatively. Two patients were received tracheotomy. Seven patients achieved good results, two of them had returned to work, and 1 patient had lived for 30 months. One patient was died of severe acute rejection (4A) at 15th postoperative day and 1 succumbed to multisystem organ failure due to severe bacterial infection combine fungal infection.


CONCLUSIONS
End-stage emphysema is an indication for single lung transplantation. Single lung transplantation with contralateral lung volume reduction is a good way to utilize donor. If patient suffered from infection, double-lung transplantation should be considered first.
Zhen
Ming-feng
MF
Center of Lung Transplant, Wuxi Fifth Hospital, Wuxi Chest Hospital, Wuxi 214073, China. zmf@hotmail.com
Chen
Jing-yu
JY
Liu
Feng
F
Dong
Shu-min
SM
He
Yi-jun
YJ
Zhu
Qian-kun
QK
Chen
Ruo
R
Ye
Shu-gao
SG
Wang
Yong-gong
YG
Zhu
Yang-hong
YH
D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000601:surgery; D011656:Pulmonary Emphysema / Q000601:surgery*; D016896:Treatment Outcome