After successful animal studies since 1986, a single left
lung transplantation was performed on a 35-year-old male patient with end-stage
silicosis in July 1991. The surgical technique was similar to that used by the Toronto Transplant Group, except for some modification in bronchial anastomosis. The donor lung was preserved by simple surface cooling after the administration of
heparin,
methylprednisolone and
PGE1. The ischemic time for the donor lung was 3.5 hours. A
cardiopulmonary bypass through the femoral vessels was applied for a duration of 90 minutes. Immediate postoperative complications included massive
bleeding,
disseminated intravascular coagulation,
adult respiratory distress syndrome and acute graft rejection. Fortunately, we overcame these complications through
intensive care. Immunosuppression included antilymphocytic
globulin,
cyclosporine,
azathioprine and
corticosteroids. The results of this single
lung transplantation were satisfactory. The patient was doing well and was able to satisfactorily breathe room air six weeks after the
transplantation. Unfortunately, the patient died of opportunistic systemic
aspergillosis six months after the
transplantation. In conclusion,
lung transplantation is an effective treatment for patients with end-stage
lung diseases, and the results of this first single
lung transplantation in Taiwan are encouraging and promising.