AF Cheriyan, ER Garrity Jr, R Pifarre, PJ Fahey and JM Walsh
Division of Pulmonary and Critical Care Medicine, Loyola University Chicago, Illinois.

Single lung transplantation is now an extremely successful option for the treatment of end-stage chronic obstructive pulmonary disease (COPD). This procedure involves placing a normal sized lung in a hyperinflated hemithorax. Preliminary observations of these patients suggest that the transplanted lung volume is smaller than expected and often the native (COPD) lung increases in volume. The purpose of this investigation was to quantify the volume contributions of the transplant and native lung to the total lung capacity. In seven patients who underwent single lung transplant for end-stage COPD the transplant and native lung volumes were measured by computer-analyzed planimetry immediately after transplant and the following 6 mo post- transplant. The transplant lung volume was smaller than predicted immediately after transplant at only 33 +/- 5% (mean +/- SD) of predicted TLC. This did not change significantly over the next 6 mo. Native lung volume increased following transplant to 74 +/- 19% predicted TLC at 1 mo and 80 +/- 16% at 6 mo. Five of the seven patients subsequently underwent measurement of pleural pressures at TLC. The mean static pleural pressure at TLC was low at -16 +/- 5.1 cm H2O. In summary, following single lung transplantation for COPD the transplanted lung is significantly restricted. We conclude that the likely mechanism of this restriction is due to low transpulmonary pressure generation.

This article has been cited by other articles:

				S. H. Loring, S. J. Mentzer, and J. J. Reilly Sources of graft restriction after single lung transplantation for emphysema J. Thorac. Cardiovasc. Surg., July 1, 2007; 134(1): 204 - 209. [Abstract] [Full Text] [PDF]

				A. De Groote, A. Van Muylem, P. Scillia, G. Cheron, G. Verleden, M. Paiva, and M. Estenne Ventilation Asymmetry after Transplantation for Emphysema: Role of Chest Wall and Mediastinum Am. J. Respir. Crit. Care Med., December 1, 2004; 170(11): 1233 - 1238. [Abstract] [Full Text] [PDF]

				F. Laghi and M. J. Tobin Disorders of the Respiratory Muscles Am. J. Respir. Crit. Care Med., July 1, 2003; 168(1): 10 - 48. [Abstract] [Full Text] [PDF]

				S. H. LORING, D. E. LEITH, M. J. CONNOLLY, E. P. INGENITO, S. J. MENTZER, and J. J. REILLY Jr. Model of Functional Restriction in Chronic Obstructive Pulmonary Disease, Transplantation, and Lung Reduction Surgery Am. J. Respir. Crit. Care Med., September 1, 1999; 160(3): 821 - 828. [Abstract] [Full Text]

				M. ESTENNE, M. CASSART, P. PONCELET, and P. A. GEVENOIS Volume of Graft and Native Lung after Single-Lung Transplantation for Emphysema Am. J. Respir. Crit. Care Med., February 1, 1999; 159(2): 641 - 645. [Abstract] [Full Text]

				T. J. Kroshus, R. M. Bolman III, and V. R. Kshettry Unilateral Volume Reduction After Single-Lung Transplantation for Emphysema Ann. Thorac. Surg., August 1, 1996; 62(2): 363 - 368. [Abstract] [Full Text]