Clinical lung and heart/lung transplantationThe US Experience with Lung Transplantation for Pulmonary Lymphangioleiomyomatosis
Section snippets
Materials and methods
We retrospectively analyzed the pooled data on 79 patients who underwent primary lung transplantation for end-stage pulmonary LAM at 31 US centers between October 1987 and December 2002 and were reported to UNOS. Follow-up data ranged from 0 to 128 months (mean, 37 months). The variables analyzed were donor and recipient demographics, cytomegalovirus (CMV) status, type of operation (single or double lung), allograft ischemia time (for double lungs, the ischemia time was considered to be that of
Results
Twelve centers reported performing 1 lung transplant each, 15 centers reported 2 to 4 transplants each, and 4 centers reported 5 or more transplants each. All recipients and 56% of the donors were women. Table 1 shows the donor and recipient age, the average time on the waiting list, the allograft cold ischemia time, and the duration of follow up. Forty-five (57%) of the 79 transplantations performed were double-lung and 34 (43%) were single-lung (Figure 1). Double-lung transplants constituted
Discussion
Pulmonary transplantation has been the treatment modality of choice for patients with end-stage lung disease due to isolated lung conditions. The last few years have witnessed an increase in lung transplantation for the treatment of respiratory failure in patients with LAM.1, 2 However, lung transplantation for patients with systemic diseases continues to generate controversy because of the shortage of donor organs and a mortality rate over 20% for patients awaiting a donor organ. The lack of
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