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Semin Respir Crit Care Med 2006; 27(5): 561-566
DOI: 10.1055/s-2006-954613
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Controversies in Lung Transplantation: Are Two Lungs Better Than One?

Denis Hadjiliadis1 , Luis F. Angel2 , 3
  • 1Division of Allergy, Pulmonary, and Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania
  • 2Division of Pulmonary and Critical Care, University of Texas Health Science Center at San Antonio, San Antonio, Texas
  • 3Division of Thoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas
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Publikationsdatum:
26. Oktober 2006 (online)

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ABSTRACT

Lung transplantation is commonly used for patients with end-stage lung disease. However, there is continuing debate on the optimal operation for patients with chronic obstructive pulmonary disease (COPD) and pulmonary fibrosis. Single-lung transplantation (SLT) provides equivalent short- and medium-term results compared with bilateral lung transplantation (BLT), but long-term survival appears slightly better in BLT recipients (especially in patients with COPD). The number of available organs for lung transplantation also influences the choice of operation. Recent developments suggest that the organ donor shortage is not as severe as previously thought, making BLT a possible alternative for more patients. Local expertise and waiting list issues are important in influencing the choice of SLT versus BLT. Most of the data support the use of BLT for the majority of COPD patients when available, and the use of SLT for the majority of idiopathic pulmonary fibrosis (IPF) patients. The ultimate choice of operation will depend on donor and recipient characteristics and local expertise and waiting list issues.

KEYWORDS

Lung transplantation - chronic obstructive pulmonary disease - idiopathic pulmonary fibrosis

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Denis HadjiliadisM.D. M.H.S. F.R.C.P.(C) F.C.C.P. 

University of Pennsylvania, Hospital of the University of Pennsylvania

835 W. Gates Bldg., 3400 Spruce St., Philadelphia, PA 19104

eMail: Denis.Hadjiliadis@uphs.upenn.edu