Surgical Techniques of Single and Bilateral Lung Transplantation
Over the past decade, single (SLTx) and bilateral (BLTx) lung transplantation have become accepted therapies for patients with end-stage lung disease. The choice between SLTx and BLTx has been primarily determined by the underlying disease process. Suppurative disorders, such as cystic fibrosis or bronchiectasis, require obligatory replacement of both lungs. Conversely, adequate correction of the physiologic defect in pulmonary fibrosis and pulmonary hypertension has been achieved with SLTx. Emphysema was originally treated with double lung or combined heart-lung transplantation so as to avoid compression of a single lung allograft by the overly compliant contralateral native lung following SLTx. Subsequent experience showed that replacement of a single lung was well tolerated. The persistent shortage of donor organs necessitates the use of single lung allografts in suitable patients to allow organ sharing. However, current data suggest that there is a survival advantage for recipients of bilateral grafts (Chapters 65 and 69). Yet providing an individual patient with two grafts may conflict with the needs of the total recipient population. This issue is particularly acute for patients with chronic obstructive lung disease.
KeywordsCystic Fibrosis Pulmonary Hypertension Lung Transplantation Double Lumen Tube Single Lung
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Daly RC, McGregor CGA. Routine immediate direct bronchial artery revascularization for single-lung transplantation. Ann Thorac Surg. 1994;57:446.CrossRefGoogle Scholar
Couraud L, Baudet E, Martigne C et al.
Bronchial revascularization in double lung transplantation. A series of 8 patients. Ann Thorac Surg. 1992;53:88.PubMedCrossRefGoogle Scholar
Triantafillou AN, Pasque MK, Huddleston CB et al.
Predictors, frequency, and indications for cardiopulmonary bypass during lung transplantation in adults. Ann Thorac Surg. 1994;57:1248.PubMedCrossRefGoogle Scholar
Spray TL, Mallory GB, Cantor CB et al.
Pediatric lung transplantation: indications, techniques, and early results. J Thorac Cardiovasc Surg. 1994;107:990.PubMedGoogle Scholar
Despotis GJ, Karanikolas M, Triantafillou AN et al.
Pressure gradient across the pulmonary artery anastomosis during lung transplantation. Ann Thorac Surg. 1994;60:630.CrossRefGoogle Scholar
Westaby S. Aprotinin in perspective. Ann Thorac Surg. 1993;55:1033.PubMedCrossRefGoogle Scholar
Date H, Trulock EP, Arcidi JM et al.
Improved airway healing after lung transplantation. An analysis of 348 bronchial anastomoses. J Thorac Cardiovasc Surg. 1995;110:1424.PubMedCrossRefGoogle Scholar
Griffith BP, Magee MJ, Gonzales IF et al.
Anastomotic pitfalls in lung transplantation. J Thorac Cardiovasc Surg. 1994;107:743.PubMedGoogle Scholar
Aoe M, Trachiotis GD, Okabayashi K et al.
Administration of prostaglandin E1 after lung transplantation improves early graft function. Ann Thorac Surg. 1994;58:655.PubMedCrossRefGoogle Scholar
Levine SM, Anzueto A, Gibbons WJ, Calhoon JH. Graft position and pulmonary function after single lung transplantation for obstructive lung disease. Chest. 1993;103:444.PubMedGoogle Scholar
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