Single and double lung transplantation.

Abstract

Lung transplantation currently involves the allografting of one or both lungs from a cadaver or brain-dead donor to selected patients with progressive end-stage pulmonary disease for whom there are no other viable treatment options. Expanding experience since 1986 in Canada, the United States, and Europe has demonstrated that both SLT and DLT can provide adequate pulmonary function and palliation for extended periods in some patients with otherwise fatal lung disease. A more rapid expansion of this technology has been constrained by the scarcity of suitable donors and the current limits of organ preservation time. Lung transplantation has evolved as a clinical procedure achieving a favorable risk-benefit ratio and acceptable 1- and 2-year survival rates. Lung transplantation is applied as a therapeutic option for patients with end-stage pulmonary disease. However, the transplant community has not yet reached consensus regarding patient selection criteria or absolute contraindications to LT. Specific selection criteria for the optimal treatment of all LT candidates do not exist as yet and are currently evolving. The majority of candidates have had pulmonary fibrosis, bronchiectasis, emphysema, pulmonary hypertension, or CF. Additional clinical information and experience will be useful in refining evaluation of risk-benefit ratios of SLT and DLT, which may vary for specific subsets of patients.