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The Annals of Thoracic Surgery, Vol 49, 785-791, Copyright © 1990 by The Society of Thoracic Surgeons
MK Pasque, JD Cooper, LR Kaiser, DA Haydock, A Triantafillou and EP Trulock
We previously described a technique for en bloc double-lung transplantation
that was initially applied to select patients with cystic fibrosis and
emphysema. This procedure is quite complex and associated with several
limitations, including a substantial incidence of airway ischemia,
postoperative myocardial depression, and cardiac denervation. To address
these problems we have developed a simpler procedure for replacing both
lungs. The operation is done through a transverse thoracosternotomy and
involves sequential replacement of the two lungs. Positive features include
separate bronchial anastomoses to reduce ischemic airway complications,
elimination of the need for total cardiopulmonary bypass and a period of
ischemic cardiac arrest, improved exposure to reduce intraoperative and
postoperative hemorrhage, and maintenance of cardiac innervation.
Additionally, the technique can be more easily mastered and widely applied.
Details of the procedure and its initial clinical application in 3 patients
having emphysema, cystic fibrosis, and bronchiolitis obliterans following
previous double-lung transplantation, respectively, are described. All 3
patients recovered without complication. Postoperative function was
excellent in spite of lung ischemic times ranging up to 91/2 hours.
ARTICLES
Improved technique for bilateral lung transplantation: rationale and initial clinical experience
Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri.
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E. N. Mendeloff, C. B. Huddleston, G. B. Mallory, E. P. Trulock, A. H. Cohen, S. C. Sweet, J. Lynch, S. Sundaresan, J. D. Cooper, and G. A. Patterson Pediatric And Adult Lung Transplantation For Cystic Fibrosis J. Thorac. Cardiovasc. Surg., February 1, 1998; 115(2): 404 - 414. [Abstract] [Full Text] [PDF]
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Y. Shiraishi, L. Ochoa, G. Richardson, J. R. Semenkovich, E. P. Trulock, S. Sundaresan, J. D. Cooper, and G. A. Patterson Retrieval by Other Procurement Teams Provides Favorable Lung Transplantation Outcome Ann. Thorac. Surg., July 1, 1997; 64(1): 203 - 206. [Abstract] [Full Text]
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J. E. Bavaria, R. Kotloff, H. Palevsky, B. Rosengard, J. R. Roberts, P. M. Wahl, N. Blumenthal, C. Archer, and L. R. Kaiser BILATERAL VERSUS SINGLE LUNG TRANSPLANTATION FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASE J. Thorac. Cardiovasc. Surg., March 1, 1997; 113(3): 520 - 528. [Abstract] [Full Text]
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J.-P. A. Couetil, M. J. Tolan, D. F. Loulmet, A. Guinvarch, P. G. Chevalier, A. Achkar, P. Birmbaum, and A. F. Carpentier PULMONARY BIPARTITIONING AND LOBAR TRANSPLANTATION: A NEW APPROACH TO DONOR ORGAN SHORTAGE J. Thorac. Cardiovasc. Surg., March 1, 1997; 113(3): 529 - 537. [Abstract] [Full Text]
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R. S. Sundaresan, Y. Shiraishi, E. P. Trulock, J. Manley, J. Lynch, J. D. Cooper, and G. A. Patterson CARDIAC AND PULMONARY REPLACEMENTSINGLE OR BILATERAL LUNG TRANSPLANTATION FOR EMPHYSEMA? J. Thorac. Cardiovasc. Surg., December 1, 1996; 112(6): 1485 - 1495. [Abstract] [Full Text]
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M. A. Norgaard, P. S. Olsen, U. G. Svendsen, and G. Pettersson Revascularization of the Bronchial Arteries in Lung Transplantation: An Overview Ann. Thorac. Surg., October 1, 1996; 62(4): 1215 - 1221. [Abstract] [Full Text]
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Y. J. Gu, J. de Haan, U. P. M. Brenken, W. J. de Boer, Jm. Prop, W. van Oeveren, and G. L. T. Group CLOTTING AND FIBRINOLYTIC DISTURBANCE DURING LUNG TRANSPLANTATION: EFFECT OF LOW-DOSE APROTININ J. Thorac. Cardiovasc. Surg., September 1, 1996; 112(3): 599 - 606. [Abstract] [Full Text]
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R. P. Brown, D. S. Esmore, and C. Lawson IMPROVED STERNAL FIXATION IN THE TRANSSTERNAL BILATERAL THORACOTOMY INCISION J. Thorac. Cardiovasc. Surg., July 1, 1996; 112(1): 137 - 141. [Abstract] [Full Text]
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H. Date, A. N. Triantafillou, E. P. Trulock, M. S. Pohl, J. D. Cooper, and G.A. Patterson INHALED NITRIC OXIDE REDUCES HUMAN LUNG ALLOGRAFT DYSFUNCTION J. Thorac. Cardiovasc. Surg., May 1, 1996; 111(5): 913 - 919. [Abstract] [Full Text]
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S. Sundaresan, E. P. Trulock, T. Mohanakumar, J. D. Cooper, and G. A. Patterson Prevalence and Outcome of Bronchiolitis Obliterans Syndrome After Lung Transplantation Ann. Thorac. Surg., November 1, 1995; 60(5): 1341 - 1346. [Abstract] [Full Text]
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J. P. A. Couetil, D. P. Houssin, O. Soubrane, P. G. Chevalier, B. E. Dousset, D. Loulmet, A. Achkar, M. J. Tolan, C. I. Amrein, A. Guinvarch, et al. COMBINED LUNG AND LIVER TRANSPLANTATION IN PATIENTS WITH CYSTIC FIBROSIS: A 4 1/2-year experience J. Thorac. Cardiovasc. Surg., November 1, 1995; 110(5): 1415 - 1423. [Abstract] [Full Text]
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H. Date, E. P. Trulock, J. M. Arcidi, S. Sundaresan, J. D. Cooper, and G. A. Patterson IMPROVED AIRWAY HEALING AFTER LUNG TRANSPLANTATIONAn analysis of 348 bronchial anastomoses J. Thorac. Cardiovasc. Surg., November 1, 1995; 110(5): 1424 - 1433. [Abstract] [Full Text]
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G. J. Despotis, M. Karanikolas, A. N. Triantafillou, C. G. Pond, G. V. Kirvassilis, G. A. Patterson, J. D. Cooper, and D. G. Lappas Pressure Gradient Across the Pulmonary Artery Anastomosis During Lung Transplantation Ann. Thorac. Surg., September 1, 1995; 60(3): 630 - 634. [Abstract] [Full Text]
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M. S. Herridge, A. L. de Hoyos, C. Chaparro, T. L. Winton, S. Kesten, and J. R. Maurer Pleural complications in lung transplant recipients J. Thorac. Cardiovasc. Surg., July 1, 1995; 110(1): 22 - 26. [Abstract] [Full Text]
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F. C. Detterbeck, T. M. Egan, and M. R. Mill Lung Transplantation After Previous Thoracic Surgical Procedures Ann. Thorac. Surg., July 1, 1995; 60(1): 139 - 143. [Abstract] [Full Text]
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S. Kesten, A. de Hoyas, C. Chaparro, G. Westney, T. Winton, and J. R. Maurer Aprotinin Reduces Blood Loss in Lung Transplant Recipients Ann. Thorac. Surg., April 1, 1995; 59(4): 877 - 879. [Abstract] [Full Text]
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J. Gorcsan III, T. D. Edwards, G. M. Ziady, W. E. Katz, and B. P. Griffith Transesophageal Echocardiography to Evaluate Patients With Severe Pulmonary Hypertension for Lung Transplantation Ann. Thorac. Surg., March 1, 1995; 59(3): 717 - 722. [Abstract] [Full Text]
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H. Date, S. Izumi, Y. Miyade, A. Andou, N. Shimizu, and S. Teramoto Successful Canine Bilateral Single-Lung Transplantation After 21-Hour Lung Preservation Ann. Thorac. Surg., February 1, 1995; 59(2): 336 - 341. [Abstract] [Full Text]
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T. M. Egan, F. C. Detterbeck, M. R. Mill, L. J. Paradowski, R. P. Lackner, W. D. Ogden, J. R. Yankaskas, J. H. Westerman, J. T. Thompson, M. A. Weiner, et al. Improved results of lung transplantation for patients with cystic fibrosis J. Thorac. Cardiovasc. Surg., February 1, 1995; 109(2): 224 - 235. [Abstract] [Full Text]
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K. Bando, J. M. Armitage, I. L. Paradis, R. J. Keenan, R. L. Hardesty, H. Konishi, K. Komatsu, K. L. Stein, A. N. Shah, H. T. Bahnson, et al. Indications for and results of single, bilateral, and heart-lung transplantation for pulmonary hypertension J. Thorac. Cardiovasc. Surg., December 1, 1994; 108(6): 1056 - 1065. [Abstract] [Full Text]
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T. L. Spray, G. B. Mallory, C. B. Canter, and C. B. Huddleston Pediatric lung transplantationIndications, techniques, and early results J. Thorac. Cardiovasc. Surg., April 1, 1994; 107(4): 990 - 1000. [Abstract] [Full Text]
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B. P. Griffith, M. J. Magee, I. F. Gonzalez, R. Houel, J. M. Armitage, R. L. Hardesty, B. G. Hattler, P. F. Ferson, R. J. Landreneau, and R. J. Keenan Anastomotic pitfalls in lung transplantation J. Thorac. Cardiovasc. Surg., March 1, 1994; 107(3): 743 - 754. [Abstract] [Full Text]
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D. H. Adams, A. D. Cochrane, A. Khaghani, J. D. Smith, and M. H. Yacoub Retransplantation in heart-lung recipients with obliterative bronchiolitis J. Thorac. Cardiovasc. Surg., February 1, 1994; 107(2): 450 - 459. [Abstract] [Full Text]
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J. D. Cooper, G. A. Patterson, E. P. Trulock, and t. W. U. L. T. Group Results of single and bilateral lung transplantation in 131 consecutive recipients J. Thorac. Cardiovasc. Surg., February 1, 1994; 107(2): 460 - 471. [Abstract] [Full Text]
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 J. D Cooper Use of aprotinin in lung transplantation Perfusion, May 1, 1993; 8(1_suppl): 43 - 46. [Abstract] [PDF]
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