Thomas P. Noeller
Management of..Pretransplant..Patients Management of Potential Donors Management of..Posttrans.p.la.n.t...Patients Early. .complications
Since the first successful single-lung transplant in 1983 followed by the first successful double-lung transplant in 1986, lung transplantation has become a viable therapeutic modality for end-stage pulmonary disease. Currently 89 centers perform lung transplants in the United States, and in 1997, a total of 942 patients underwent lung transplant nationally.1 On December 31, 1997, the United Network for Organ Sharing listed 2664 patients on a waiting list for lung transplantation and noted that 409 patients had been removed from a waiting list owing to death during that year. For the most recent year that full data are available, the median waiting time for lung transplantation during 1996 was 566 days after being placed on a waiting list. 2 Overall, survival rates as of September 1997 were 91 percent at 1 month and 77, 58, and 43 percent at 1, 3, and 5 years, respectively.2 The long-term survival rates were slightly higher at centers performing more than 30 lung transplants per year. Single and double lung transplants as well as heart-lung transplants are most commonly performed for cystic fibrosis, idiopathic pulmonary fibrosis, and emphysema, including alpharantitrypsin deficiency. Congenital heart disease and Eisenmenger complex may also be indications for heart-lung transplantation.
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