Objective: To review the experience with the management of single lung transplantation for emphysema.
Methods: Between January 2003 and August 2006, single lung transplantation was performed in 6 patients for emphysema with cold low potassium solution flushing. A triple-drug regimen was adopted using steroids, mycophenolate mofetil and tacrolimus as the maintenance immunosuppressants. Chest radiograph score, oxygenation index, and pulmonary arterial pressure of the patients in early after the transplantation were reviewed.
Results: All the 6 patients survived for over 30 days after the operation, and 4 of them remained alive with good quality-of-life. Four patients recovered from acute rejection successfully after methylprednisolone pulse therapy for 3 days. One patient underwent reoperation for hemorrhage in the thoracic cavity and finally recovered; spontaneous pneumothorax of the autologous lungs occurred in two patients, who underwent reoperation but finally died 74 days and 77 days after the transplantation, respectively.
Conclusion: Single lung transplantation is effective for end-stage emphysema. Carefully selected recipients and comprehensive design of the surgical procedures are critical to successful lung transplantation.