European Journal of Cardio-Thoracic Surgery, Vol 6, 550-554, Copyright © 1992 by European Association for Cardio-thoracic Surgery
Bilateral single lung transplantation. Complications and results in 14 patients
P Bonnette, A Bisson, NB el Kadi, A Colchen, M Leroy, M Fischler, P Loirat and I Caubarere
Department of Thoracic Surgery, Centre Medico-Chirurgical Foch, Suresnes, France.
Between November 1989 and April 1991, 14 bilateral single lung
transplantations (BSLT) were performed at our institution using the
technique we have described without omentoplasty and rarely cardiopulmonary
bypass. The indications included emphysema (8), cystic fibrosis (3),
infected fibrosis (1), alveolar microlithiasis (1) and lymphocytic
interstitial pneumonitis (1). Maximum mean pulmonary artery pressure was 53
mmHg and minimal right ventricular ejection fraction was 15%. Two patients
experienced bronchial complications: 1 complete left bronchial dehiscence,
1 late partial stenosis which required a temporary insertion of a stent.
One patient had a posterior dehiscence which healed spontaneously. Five
patients died postoperatively (3 of infection, 1 after a volume mismatch
and 1 after a circulating anticoagulant). BSLT is the technique of choice
for double lung transplantation in adults and heart lung transplantation
has very few indications in infected end-stage pulmonary disease. We hope
that modification of our immunosuppressive regimen will decrease
postoperative mortality.
