• H Mal, B Andreassian, F Pamela, J P Duchatelle, E Rondeau, F Dubois, P Baldeyrou, M Kitzis, C Sleiman, and R Pariente.
• Service de Pneumologie et Réanimation, Hôpital Beaujon, Clichy, France.
• Am. Rev. Respir. Dis. 1989 Sep 1; 140 (3): 797-802.

AbstractPatients with end-stage pulmonary emphysema are usually proposed for either heart-lung or double-lung transplantation. The single-lung transplantation is reversed for patients with pulmonary fibrosis. Patients with emphysema are thought to be unsuitable for single-lung transplantation because of the ventilation-perfusion imbalance that is supposed to occur, the ventilation being preferentially distributed to the native lung when the perfusion is distributed to the transplanted lung. We now report a preliminary success with single-lung transplantation in two consecutive patients with end-stage pulmonary emphysema. Despite the persistence after transplantation of an obstructive syndrome, the clinical status was good, the blood gases were markedly improved, and ventilation-perfusion imbalance did not occur on lung scans. After discharge from the hospital, the patients could return to an almost normal life. Thus, our data support the feasibility of single-lung transplantation in patients with end-stage pulmonary emphysema, and we consider that single-lung transplantation could be the optimal form of lung transplantation in these patients.

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