Results of Single-Lung Transplantation for Bilateral Pulmonary Fibrosis

R. F. Grossman, A. Frost, N. Zamel, G. A. Patterson, J. D. Cooper, P. R. Myron, C. L. Dear, J. Maurer

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194 Scopus citations


Between November 1983 and August 1989, we performed single-lung transplantation for end-stage pulmonary fibrosis in 20 patients. Nine patients (45 percent) who survived for more than one year form the basis of this report. Before surgery, the nine survivors had severe restrictive lung disease, with a mean (±SD) vital capacity (VC) of 43±9 percent, a forced expiratory volume in one second (FEV1) of 50±9 percent, and a single-breath diffusing capacity (DLCO) of 36±9 percent of predicted values. One year after transplantation, the patients' VC had reached 69±10 percent, FEV1 79±15 percent, and DLCO 62±16 percent of predicted values. Relative perfusion to the transplanted lung rose from 63±14 percent (three days after surgery) to 77±7 percent within three months and stayed constant or increased slightly thereafter. Before surgery, despite supplemental oxygen at flow rates varying from 1 to 9 liters per minute, none of the patients could exercise beyond stage 1/2 (2.7 km [1.7 miles] per hour, 5 percent grade) on a modified Bruce treadmill-exercise protocol. All eight patients tested one year or more after transplantation achieved at least stage 1 (2.7 km [1.7 miles] per hour, 10 percent grade), and usually a higher stage, without supplemental oxygen. Arterial oxygen tension returned to normal values in most patients (87±13 mm Hg), and supplemental oxygen, which all patients required before surgery, was no longer needed by any patient after transplantation. We conclude that in carefully selected patients with end-stage pulmonary fibrosis, single-lung transplantation is an effective treatment. SINCE the publication of our preliminary report describing the operative procedure and early improvement in lung function in the first two successful single-lung transplantations,1 the procedure has been used to treat selected patients with end-stage pulmonary fibrosis. As of August 1989, we had performed 20 single-lung transplantations in patients with pulmonary fibrosis. At that time, 9 patients had survived for more than one year (11 in all were alive; 1 patient had died 18 months after surgery, and 3 others were alive less than one year after surgery). The nine patients who had survived for one year or more form…

Original languageEnglish (US)
Pages (from-to)727-733
Number of pages7
JournalNew England Journal of Medicine
Issue number11
StatePublished - Mar 15 1990

ASJC Scopus subject areas

  • Medicine(all)


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