Chest, Vol 98, 1107-1115, Copyright © 1990 by American College of Chest Physicians

ARTICLES

Single lung transplantation for primary pulmonary hypertension

SM Levine, WJ Gibbons, CL Bryan, AD Walling, RW Brown, SR Bailey, T Cronin, JP Calhoon, JK Trinkle and SG Jenkinson
Department of Medicine, University of Texas Health Science Center, San Antonio.

Single lung transplantation has become a therapeutic option for end- stage interstitial lung disease and obstructive lung disease. Our group recently extended this treatment to three patients with primary pulmonary hypertension. All patients had marked decreases in pulmonary artery pressures and pulmonary vascular resistance and increases in cardiac output following single lung transplantation. Spirometry, lung volumes, and diffusion capacity were not different in comparison to preoperative studies. Quantitative ventilation-perfusion scans revealed the majority of perfusion distributed to the transplanted lung, with ventilation approximately equally divided between the native and the transplanted lung. Despite ventilation-perfusion imbalance, there was no resting hypoxemia and there was no arterial oxygen desaturation with exercise. One patient expired on the 30th postoperative day due to cytomegalovirus infection of the lungs. In the remaining two patients, maximum exercise capacity following transplantation was near normal in one recipient and reduced in the second recipient. Of note, there was no evidence of ventilatory limitation or impaired oxygenation during exercise in these two recipients. Although an exaggerated exercise ventilatory response was present, this did not limit exercise performance. This report supports the use of single lung transplantation for the treatment of primary pulmonary hypertension.

This article has been cited by other articles:

				Y. Villaran, M. E. Sekela, and N. K. Burki Maximal Expiratory Flow Patterns After Single-Lung Transplantation in Patients With and Without Chronic Airways Obstruction Chest, January 1, 2001; 119(1): 163 - 168. [Abstract] [Full Text] [PDF]

				B. Gridelli and G. Remuzzi Strategies for Making More Organs Available for Transplantation N. Engl. J. Med., August 10, 2000; 343(6): 404 - 410. [Full Text] [PDF]

				R. I. Whyte, R. C. Robbins, J. Altinger, C. W. Barlow, R. Doyle, J. Theodore, and B. A. Reitz Heart-lung transplantation for primary pulmonary hypertension Ann. Thorac. Surg., April 1, 1999; 67(4): 937 - 941. [Abstract] [Full Text] [PDF]

				O. Sanchez, M. Humbert, O. Sitbon, and G. Simonneau Treatment of pulmonary hypertension secondary to connective tissue diseases Thorax, March 1, 1999; 54(3): 273 - 277. [Full Text]

				S. Seki, N. A. Flavahan, N. G. Smedira, and P. A. Murray Superoxide anion scavengers restore NO-mediated pulmonary vasodilation after lung transplantation Am J Physiol Heart Circ Physiol, January 1, 1999; 276(1): H42 - H46. [Abstract] [Full Text] [PDF]

				K. Yoshida, N. A. Flavahan, M. Horibe, N. G. Smedira, and P. A. Murray Endothelial defect mediates attenuated vasorelaxant response to isoproterenol after lung transplantation Am J Physiol Heart Circ Physiol, January 1, 1999; 276(1): H159 - H166. [Abstract] [Full Text] [PDF]

				M. Okada, C. Yamashita, M. Okada, and K. Okada A DEHYDROMONOCROTALINE-INDUCED PULMONARY HYPERTENSION MODEL IN THE BEAGLE J. Thorac. Cardiovasc. Surg., August 1, 1995; 110(2): 546 - 547. [Full Text]

				K. Bando, J. M. Armitage, I. L. Paradis, R. J. Keenan, R. L. Hardesty, H. Konishi, K. Komatsu, K. L. Stein, A. N. Shah, H. T. Bahnson, et al. Indications for and results of single, bilateral, and heart-lung transplantation for pulmonary hypertension J. Thorac. Cardiovasc. Surg., December 1, 1994; 108(6): 1056 - 1065. [Abstract] [Full Text]