European Journal of Cardio-Thoracic Surgery, Vol 11, 604-608, Copyright © 1997 by European Association for Cardio-thoracic Surgery
Early experience with single lung transplantation for emphysema with simultaneous volume reduction of the contralateral lung
A Khaghani, KM al-Kattan, S Tadjkarimi, N Banner and M Yacoub
Transplant Unit, Harefield Hospital, Middlesex, UK.
OBJECTIVE: Single lung transplantation (SLT) for emphysema has given
satisfactory long term results in most patients. The mediastinal shift
caused by the native emphysematous lung may require further surgical
intervention in selected cases. METHODS: We report a technique of
simultaneous SLT and volume reduction of the contralateral lung in 4
patients with end stage respiratory failure secondary to emphysema. There
were two right and two left SLT, performed in two male and two female
patients. Their mean age was 52.2 (S.D. 4) years (range between 41 and 57
years) and the ischaemia time averaged 255.6 (S.D. 16) min (range between
225 and 255 min). The volume of the contralateral lung was reduced using
staples. The stapled lines were buttressed by the donors pericardium.
RESULTS: Their were no operative related complications apart from air leak
which settled spontaneously within 5 days postoperatively. Teh
pre-operative FEVI showed a mean value of 0.57 (S.D. 0.1) L (17.2% (S.D. 2)
of the predicted) which improved to 1.79 (S.D. 0.4) L (58.2% (S.D. 8) of
the predicted) at last follow up (P < 0.005). Radiological examinations
at 1 year showed central mediastinum with satisfactory respiratory
function. CONCLUSION: We conclude that this technique can be performed for
patients with emphysema without increase in the operative morbidity and
with good early respiratory function. Further follow up is required to
assess the long term results of this procedure.
