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J Thorac Cardiovasc Surg 1999;117:404-405
© 1999 Mosby, Inc.

LETTERS TO THE EDITOR

Single or double lung transplantation for pulmonary hypertension

We hope to clarify the concerns expressed by Park and his colleagues regarding articles published by our group on the issue of single (SLT) versus double lung transplantation (DLT) for pulmonary hypertension. The original article reported an early experience with SLT for patients with pulmonary hypertension: it comprised patients undergoing transplantation from 1990 through late 1992 and included an analysis of 10 SLTs for pulmonary vascular disease and 9 for parenchymal disease with pulmonary hypertension as an associated finding. ¹ The former group had systemic pulmonary artery pressures, whereas the latter had substantially lower pulmonary artery pressures. Follow-up was less than 18 months. The more recent article included patients undergoing transplantation through 1996 (including 10 patients from the earlier series) and focused on those with pulmonary vascular disease. ² The mean pulmonary artery systolic pressure of this cohort was 100 mm Hg. Thus we were able to compare 37 DLTs and 21 SLTs for pulmonary vascular disease, with a mean follow-up in excess of 3 years. The survival data are unequivocal, demonstrating identical survival in the SLT and DLT groups. The improved results over time of SLT for pulmonary hypertension likely reflect the growing maturity of our program, inasmuch as we have gained experience with donor selection and perioperative management. Our data are strikingly similar to those of the St Louis program, which reported a 3-year survival of 61% among 34 consecutive SLTs for pulmonary hypertension. ³

The earlier paper concluded, "Further study comparing single versus bilateral lung transplantation for pulmonary hypertension is necessary." We believe that our most recent experience, with nearly 6 times as many patients with pulmonary vascular disease, represents just that.

James S. Gammie, MD
Robert J. Keenan, MD
Si M. Pham, MD
Michael F. McGrath, MD
Brack G. Hattler, MD
Espeed Khoshbin, MD
Bartley P. Griffith, MD
Division of Cardiothoracic Surgery
University of Pittsburgh Medical Center
C-700 Scaife Hall
Pittsburgh, PA 15213

12/8/93652

References

1. Bando K, Keenan RJ, Paradis IL, Konishi H, Komatsu K, Hardesty RL, et al. Impact of pulmonary hypertension on outcome after single-lung transplantation. Ann Thorac Surg 1994;58:1336-42. [Abstract/Free Full Text]
   
2. Gammie JS, Keenan RJ, Pham SM, McGrath MF, Hattler BG, Khoshbin E, et al. Single- versus double-lung transplantation for pulmonary hypertension. J Thorac Cardiovasc Surg 1998;115:397-403. [Abstract]
   
3. Pasque MK, Trulock EP, Cooper JD, et al. Single lung transplantation for pulmonary hypertension: single institution experience in 34 patients. Circulation 1995;92:2252-8. [Abstract/Free Full Text]
   

This article has been cited by other articles:

				J. V. Conte, M. J. Borja, C. B. Patel, S. C. Yang, R. M. Jhaveri, and J. B. Orens Lung transplantation for primary and secondary pulmonary hypertension Ann. Thorac. Surg., November 1, 2001; 72(5): 1673 - 1680. [Abstract] [Full Text] [PDF]

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