PURPOSE: Clinical lung transplantation was initiated at our institution in 1991. Since then, 512 transplants have been performed in 502 patients. The indications, procedures and outcomes were analyzed.
METHODS: All patients undergoing lung transplantation at our institution since the inception of the program were retrospectively analyzed. Diagnoses, operative procedures and survival were examined and compared among groups.
RESULTS: The most common indications for lung transplantation were chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF) and cystic fibrosis (CF). COPD patients had the best survival at all endpoints. Double lung transplantation for COPD appears to provide a greater survival benefit over single lung transplantation. However, this may reflect patient selection. Recently, more patients with IPF are being transplanted. In 2002, IPF patients accounted for 18% of transplants and by 2006 IPF was the indication for 31% of all transplants. In IPF patients, it appears that survival with single lung transplantation is greater than with double lung transplantation. Again this may reflect selection. Also more patients are being transplanted on CPB. Since 2003 the percentage of patients undergoing transplantation with CPB has increased, from 24% in 2003 to 42% in 2005. Since 2001 all CF patients have been transplanted on CPB.
CONCLUSION: Our lung transplant experience of 502 patients compares favorably to reported ISHLT worldwide registry outcomes. Survival appears to be higher in bilateral lung transplantation for COPD and higher in single lung transplantation for IPF.
CLINICAL IMPLICATIONS: In appropiately selected patients bilateral lung transplantation should be preferably performed for patients with COPD and single lung transplantation should be preferably performed for patients with IPF.
DISCLOSURE: Y. Woo, No Financial Disclosure Information; No Product/Research Disclosure Information