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AbstractThe long-term prognosis following lung transplantation (LTX) depends mainly on the development of chronic rejection which appears clinically as deterioration of the lung function while, histologically, obliterative bronchiolitis (OB) is found. However, it still remains questionable whether heart-lung (HL), double or single lung (DL/SL) transplants behave similarly with regard to incidence and time pattern. Eighty-two patients, transplanted until August 92, were analyzed. Early and late deaths within 180 days postoperatively were excluded. A total of 64 patients at risk could be evaluated. By repeated lung function tests, obstructive airway disease was defined by a drop of 25% or more of the forced expiratory volume in one second (FEV1) in percent of the inspiratory vital capacity. Results: The functional optimum after transplantation was reached after acomparable time-span postoperatively in all groups. Chronic deteriorationof the lung function developed earlier following DLTX compared to HLTX andSLTX. Obstructive airway disease was diagnosed in 9/20 (45%) HL, 7/19 (37%)DL, and 7/25 (28%) SL patients. Of these, 4 died and 4 had to beretransplanted for the disease while an additional 15 patients arecurrently under investigation. It is concluded that the development ofobstructive airway disease represents a serious problem in all types oflung transplantation. There is a tendency to earlier development followingDLTX--perhaps caused by the greatest immunological potential in this groupof patients.
European Journal of Cardio-Thoracic Surgery – Oxford University Press
Published: Jun 1, 1993
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