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The Annals of Thoracic Surgery, Vol 54, 27-31, Copyright © 1992 by The Society of Thoracic Surgeons

ARTICLES

Double-lung transplantation for cystic fibrosis. The Cystic Fibrosis Transplant Study Group

H Shennib, M Noirclerc, P Ernst, D Metras, DS Mulder, R Giudicelli, F Lebel and JF Dumon
Thoracic Surgery Departments, Ste-Marguerite Hospital, Marseille, France.

One hundred twenty cystic fibrosis patients were accepted for transplantation. Twenty-five patients underwent double-lung transplantation. Twenty-five patients died awaiting transplantation (20.6%). There were 13 female and 12 male patients. Their mean age was 28 years (range, 7 to 34 years), and mean percentage ideal body weight was 76% (range, 58.5% to 91.9%). Most patients were hypoxic and hypercarbic. Two patients underwent tracheal anastomosis, 15 had en bloc bronchial anastomoses, and 8 had sequential single-lung transplants. Operative mortality was 16%; all deaths were related to bleeding from extensive adhesions. Actuarial survival at 1 year was 64%. Rejection and infection were frequent during the first month and decreased thereafter. Airway complications occurred in 5 patients but were amenable to laser therapy and stenting. We conclude that double- lung transplantation is an acceptable modality for the treatment of cystic fibrosis patients with end-stage lung disease. It may be a better alternative to heart-lung transplantation considering the paucity of thoracic organ donors.

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