Comparison of single lung transplant with and without the use of cardiopulmonary bypass.
OBJECTIVE
Many centres avoid using cardiopulmonary bypass (CPB) for lung transplant due to concerns over aggravated lung reperfusion injury and excessive blood loss. We reviewed our 23-years' experience of single lung transplantation.


METHODS
A retrospective review of single lung transplants at our institution (1987-2010), examining differences in allograft function and postoperative complications between CPB and non-bypass (non-CPB) cases.


RESULTS
Two hundred and fifty-nine single lung transplants were undertaken. Fifty-three (20.5%) with CPB. There was no difference demographically between the two groups. No difference existed in preoperative PO(2)/FiO(2). At 1 and 24 h, the postoperative PO(2)/FiO(2) ratio was no different (mean 2.95 and 3.24 in non-CPB cases; 3.53 and 3.75 in CPB patients, P = 0.18 and P = 0.34, respectively). Extubation time was not influenced by the use of CPB. Postoperative blood loss was greater in the CPB group. The usage of fresh frozen plasma and platelets was similar (P = 0.64 and 0.41, respectively). More blood was transfused during postoperative care of CPB patients (P = 0.02).


CONCLUSIONS
Fears of poor postoperative lung function after CPB appear unfounded. We could detect no difference in function or extubation time. Although the use of CPB increases postoperative bleeding and the need for transfusion, it may be used safely to facilitate lung transplantation.
Freeman Hospital, Newcastle-upon-Tyne, UK. clare.burdett@ncl.ac.uk
Clare
C
Burdett
Tanveer
T
Butt
Jim
J
Lordan
John H
JH
Dark
Stephen C
SC
Clark
D000293:Adolescent; D000328:Adult; D000368:Aged; D002315:Cardiopulmonary Bypass / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000601:surgery*; D015994:Incidence; D016040:Lung Transplantation / Q000379:methods* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D011184:Postoperative Period; D015427:Reperfusion Injury / Q000453:epidemiology; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult