ABSTRACT
Pulmonary Vascular Disease This condition may be either primary or secondary to congenital heart disorders or collagen vascular disease. Some centers advocate a double-lung allograft, but the majority of recipi ents receiving a single lung for this indication have also done well. As with interstitial lung disease that is complicated by pulmonary hypertension, the risk of primary graft failure due to acute ischemia-reperfusion injury is heightened when the majority of the
cardiac output flows through the newly transplanted lung. Severe decompensation in lung function later in the postoperative course due to infection and/or rejection is also more likely in single-lung recipients transplanted for pulmonary hypertension than in recipients who receive a double allograft for this indication. Nonetheless, transplantation of a single lung for patients with pulmonary hypertension remains an accepted approach because there does not seem to be a major difference in outcome, and single-lung allografting is a more efficient utilization of a scarce resource. When the congenital heart defect that caused the pulmonary hypertension is not correctable, combined heart and lung trans plantation is necessary.
