Human lung allotransplantation. Report of two cases.

Abstract Although canine lung allografts have survived with function for periods up to five years, to date human lung allotransplantation has been unsuccessful with the exception of one patient now surviving more than six months after operation. This report reviews two cases of left lung transplantation for terminal pulmonary emphysema associated with serum alpha-1 globulin or antitrypsin deficiency. These patients died twenty-six and ten days after operation, respectively, and the causes of death were herpes simplex viral pneumonia in the first and bacterial pneumonia with lung abscess formation in the second. The second case was particularly disappointing in that mechanical lymphocyte depletion rather than conventional immunosuppressive therapy was employed in an attempt to prevent infectious complications. Problems encountered in the management of these patients are numerous. Many of the findings of previous experimental studies may not be applicable to the clinical situation, and much remains to be learned about human lung allotransplantation.