TY - JOUR
T1 - Single lung transplantation for pulmonary hypertension
T2 - Single institution experience in 34 patients
AU - Pasque, Michael K.
AU - Trulock, Elbert P.
AU - Cooper, Joel D.
AU - Triantafillou, Anastasios N.
AU - Huddleston, Charles B.
AU - Rosenbloom, Michael
AU - Sundaresan, Sudhir
AU - Cox, James L.
AU - Patterson, G. Alexander
PY - 1995/10/15
Y1 - 1995/10/15
N2 - Background The present study considered the uniformity and durability of the cardiopulmonary response to single lung transplantation in patients with severe pulmonary hypertension, as well as its effect on length and quality of survival. Methods and Results: Thirty-four patients with pulmonary hypertension underwent evaluation, single lung transplantation, and follow- up assessment between November 1, 1989, and June 1, 1994. Operative survival for the entire group of patients was reasonable with 91% (31 of 34 patients) surviving and being discharged from the hospital following transplantation. The actuarial survival for these 34 patients at 1-, 2-, and 3-year follow-up was 78%, 66%, and 61%, respectively. In the subgroup of 24 patients with primary pulmonary hypertension (PPH), 96% (23 of 24) were successfully discharged from the hospital after transplantation. The actuarial survival for this isolated PPH subgroup at 1-, 2-, and 3-year follow-up was 87%, 76%, and 68%, respectively. The uniform, early posttransplant normalization of pulmonary vascular resistance and right ventricular ejection fraction appears to persist throughout the 4-year follow-up period. Despite a high prevalence of bronchiolitis obliterans, the majority of survivors remain in New York Heart Association functional class I or II and are employed. Conclusions: Single lung transplantation can be performed in patients with end-stage pulmonary vascular disease with reasonable expectations for a relatively low operative mortality; immediate, complete, and durable amelioration of pulmonary hypertension and right ventricular failure; and optimal use of limited donor organ supply.
AB - Background The present study considered the uniformity and durability of the cardiopulmonary response to single lung transplantation in patients with severe pulmonary hypertension, as well as its effect on length and quality of survival. Methods and Results: Thirty-four patients with pulmonary hypertension underwent evaluation, single lung transplantation, and follow- up assessment between November 1, 1989, and June 1, 1994. Operative survival for the entire group of patients was reasonable with 91% (31 of 34 patients) surviving and being discharged from the hospital following transplantation. The actuarial survival for these 34 patients at 1-, 2-, and 3-year follow-up was 78%, 66%, and 61%, respectively. In the subgroup of 24 patients with primary pulmonary hypertension (PPH), 96% (23 of 24) were successfully discharged from the hospital after transplantation. The actuarial survival for this isolated PPH subgroup at 1-, 2-, and 3-year follow-up was 87%, 76%, and 68%, respectively. The uniform, early posttransplant normalization of pulmonary vascular resistance and right ventricular ejection fraction appears to persist throughout the 4-year follow-up period. Despite a high prevalence of bronchiolitis obliterans, the majority of survivors remain in New York Heart Association functional class I or II and are employed. Conclusions: Single lung transplantation can be performed in patients with end-stage pulmonary vascular disease with reasonable expectations for a relatively low operative mortality; immediate, complete, and durable amelioration of pulmonary hypertension and right ventricular failure; and optimal use of limited donor organ supply.
KW - hypertension, pulmonary
KW - lung
KW - transplantation
UR - http://www.scopus.com/inward/record.url?scp=0028803137&partnerID=8YFLogxK
U2 - 10.1161/01.CIR.92.8.2252
DO - 10.1161/01.CIR.92.8.2252
M3 - Article
C2 - 7554209
AN - SCOPUS:0028803137
SN - 0009-7322
VL - 92
SP - 2252
EP - 2258
JO - Circulation
JF - Circulation
IS - 8
ER -