Bilateral single lung transplantation Complications and results in 14 patients

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Abstract
Between November 1989 and April 1991, 14 bilateral single lungtransplantations (BSLT) were performed at our institution using thetechnique we have described without omentoplasty and rarely cardiopulmonarybypass. The indications included emphysema (8), cystic fibrosis (3),infected fibrosis (1), alveolar microlithiasis (1) and lymphocyticinterstitial pneumonitis (1). Maximum mean pulmonary artery pressure was 53mmHg and minimal right ventricular ejection fraction was 15%. Two patientsexperienced 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. Fivepatients died postoperatively (3 of infection, 1 after a volume mismatchand 1 after a circulating anticoagulant). BSLT is the technique of choicefor double lung transplantation in adults and heart lung transplantationhas very few indications in infected end-stage pulmonary disease. We hopethat modification of our immunosuppressive regimen will decreasepostoperative mortality.

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