Experience in Clinical Lung Transplantation

Observations on two patients who received single lung allografts indicate that one transplanted lung can provide total gas exchange while carrying virtually the entire cardiac output at tolerable pulmonary-artery pressures (18 to 19 mm Hg), and that human lung allograft rejection can be reversed with corticosteroid treatment. Although the remaining emphysematous lung in one patient had high vascular resistance, compliance, and expiratory airway resistance, it appears that the resulting ventilation-perfusion imbalances did not produce serious respiratory insufficiency until allograft rejection further impaired transplant ventilation. Thus, better immunosuppression, rather than bilateral procedures, is a pressing need in lung transplantation.