Abstract | OBJECTIVE: To report functional results and survival in patients undergoing single lung transplantation (SLT) for pulmonary involvement associated with systemic disease or prior malignancy, criteria traditionally considered contraindications to SLT. DESIGN: Case series. SETTING: The University of Texas Health Science Center at San Antonio. PATIENTS: MEASUREMENTS: Pulmonary function testing, exercise oximetry, quantitative ventilation-perfusion lung scanning. Actuarial survival. RESULTS: All patients had marked improvement in pulmonary function, exercise oximetry, and quantitative ventilation perfusion to the SLT. One patient with scleroderma died 90 days postoperatively from Pseudomonas pneumonia with a sepsis syndrome. One patient with sarcoidosis died 150 days postoperatively from disseminated aspergillosis. At autopsy, there was no evidence of recurrent fibrosis or sarcoidosis in the transplanted lungs in either of these two patients. The seven surviving patients have returned to work or school and are conducting all activities of daily living without pulmonary disability. The 1- and 2-year actuarial survival rates in these nine patients is 68.6 percent as compared with the 1- and 2-year actuarial survival rates of 66.3 percent and 55.8 percent in the remainder of our SLT group as a whole (n = 49). Despite pharmacologic immunosuppression, there is no evidence of recurrent malignancy in the 3 patients with prior malignancies. CONCLUSIONS: We conclude that carefully selected patients with end-stage lung involvement related to systemic disease or chemotherapy-induced fibrosis may benefit from SLT.
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Authors | S M Levine, A Anzueto, J I Peters, J H Calhoon, S G Jenkinson, C L Bryan |
Journal | Chest
(Chest)
Vol. 105
Issue 3
Pg. 837-41
(Mar 1994)
ISSN: 0012-3692 [Print] United States |
PMID | 7510601
(Publication Type: Case Reports, Journal Article, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
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Topics |
- Adult
- Aspergillosis
(complications)
- Bleomycin
(adverse effects)
- Female
- Follow-Up Studies
- Humans
- Lung Diseases
(etiology, surgery)
- Lung Transplantation
(mortality, physiology)
- Male
- Middle Aged
- Pulmonary Fibrosis
(chemically induced, surgery)
- Sarcoidosis, Pulmonary
(surgery)
- Scleroderma, Systemic
(complications)
- Survival Rate
- Time Factors
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