OUTCOME OF THE NATIVE LUNG AFTER SINGLE-LUNG TRANSPLANT

Twenty-one long-term survivors of single lung transplant since 1987 have been followed from 7 to 81 months. Posttransplant complications unique to the native lung and their impact on patient outcome are reported. In 7 of 21 recipients of single lung transplant, clinical complications in the native lung developed, including infection, pulmonary infarction, and severe ventilation-perfusion mismatching. Impact on the patient has ranged from little effect (prolongation of hospital or ICU stay) to recurrent severe infections, the need for surgical intervention, and a possible contribution to the recurrence of original disease-giant cell interstitial pneumonitis. The remaining native lung can be a source of significant complications following single lung transplant. Pretransplant diagnoses other than uncomplicated idiopathic pulmonary fibrosis seem to be most frequently associated with compromise of function or risk of infection arising from the native lung.