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The Journal of Thoracic and Cardiovascular Surgery, Vol 103, 475-481, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
MK Pasque, LR Kaiser, CM Dresler, E Trulock, AN Triantafillou and JD Cooper
Donor availability has limited the clinical applicability of heart-lung
transplantation in patients with end-stage pulmonary hypertension.
Satisfaction with single lung transplantation in other patient groups
prompted its extension to patients with pulmonary hypertension. Nine
patients with end-stage pulmonary hypertension underwent single lung
transplantation. Important technical considerations included routine use of
cardiopulmonary bypass, simultaneous closure of significant associated
cardiac defects (n = 4), and use of remaining thoracic donor organs in
multiple recipients (total thoracic transplants from eight donors = 21).
Analysis of immediate postoperative hemodynamics suggests that early relief
of pulmonary hypertension and improvement in right ventricular function can
be expected. There was one postoperative death. Eight patients have been
discharged and are alive and well at a mean follow-up period of 1 year. All
eight survivors have returned to New York Heart Association functional
class I from their preoperative levels of III or IV. These results support
the use of single lung transplantation as a transplant option in patients
with end-stage pulmonary hypertension. The question of long-term durability
remains unanswered.
ARTICLES
Single lung transplantation for pulmonary hypertension. Technical aspects and immediate hemodynamic results
Department of Surgery, Washington University School of Medicine, Barnes Hospital, St. Louis, Mo 63110.
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