Bilateral sequential single lung transplantation for pulmonary hypertension and Eisenmenger’s syndrome

Background. Lung transplantation, with and without intracardiac repair for pulmonary hypertension (PH) and Eisenmenger’s syndrome (EIS), has become an alternative transplant strategy to combined heart and lung transplantation (HLT). Methods. Thirty-five patients with PH or EIS underwent either bilateral sequential single lung transplantation (BSSLT, group I, n = 13) or HLT (group II, n = 22). Another 74 patients, who underwent BSSLT for other indications, served as controls (group III). Immediate allograft function, early and medium-term outcomes, lung function, and 2-year survival were compared between the groups. Results. Comparisons between groups I and II showed no significant difference in any variables except percent predicted forced vital capacity. Immediate allograft function was significantly inferior (p< 0.05) and the blood loss was greater (p< 0.01) in group I when compared with those in group III. However, this resulted in no significant difference in early and medium-term outcomes, and 2-year survival between the 2 groups. Conclusions. BSSLT for PH and EIS can be performed as an alternative procedure to HLT without an increase in early and medium-term morbidity and mortality. Results are comparable with BSSLT performed for other indications.