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. 1998 Apr;53(4):281–284. doi: 10.1136/thx.53.4.281

Medium term results of lung transplantation for end stage pulmonary sarcoidosis

S Walker 1, G Mikhail 1, N Banner 1, J Partridge 1, A Khaghani 1, M Burke 1, M Yacoub 1
PMCID: PMC1745184  PMID: 9741371

Abstract

BACKGROUND—Lung transplantation is an accepted therapeutic option for patients with end stage pulmonary sarcoidosis. However, the medium term outcome of transplantation in this patient group is unknown.
METHODS—This study was performed to evaluate our experience with lung transplantation for end stage pulmonary sarcoidosis. Between July 1988 and July 1997 12 patients (nine men) underwent lung transplantation for sarcoidosis at our institution. Ten underwent single lung transplantation and two double lung transplantation.
RESULTS—Survival at three and five years was 70% and 56%, respectively. Three patients developed obliterative bronchiolitis at six, 18, and 45 months. One died at the time of retransplantation. Sarcoid granulomas have recurred in the donor organ in three patients. In one the development of granulomas has been associated with clinical deterioration, necessitating retransplantation. Mean (SD) forced expiratory volumes in one second at three and five years were 1.37 (0.67) l and 1.34 (0.13) l, respectively.
CONCLUSIONS—Lung transplantation is a viable option for patients with end stage pulmonary sarcoidosis. The medium term results are comparable with patients undergoing lung transplantation for other indications. Despite histological recurrence of sarcoidosis, the risk of clinically important recurrence is low.



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Selected References

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  1. Bjørtuft O., Foerster A., Boe J., Geiran O. Single lung transplantation as treatment for end-stage pulmonary sarcoidosis: recurrence of sarcoidosis in two different lung allografts in one patient. J Heart Lung Transplant. 1994 Jan-Feb;13(1 Pt 1):24–29. [PubMed] [Google Scholar]
  2. Brown J. H., Jos V., Newstead C. G., Lawler W. Sarcoid-like granulomata in a renal transplant. Nephrol Dial Transplant. 1992;7(2):173–173. doi: 10.1093/oxfordjournals.ndt.a092094. [DOI] [PubMed] [Google Scholar]
  3. Carré P., Rouquette I., Durand D., Didier A., Dahan M., Fournial G., Léophonte P. Recurrence of sarcoidosis in a human lung allograft. Transplant Proc. 1995 Apr;27(2):1686–1686. [PubMed] [Google Scholar]
  4. Cooper J. D., Billingham M., Egan T., Hertz M. I., Higenbottam T., Lynch J., Mauer J., Paradis I., Patterson G. A., Smith C. A working formulation for the standardization of nomenclature and for clinical staging of chronic dysfunction in lung allografts. International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 1993 Sep-Oct;12(5):713–716. [PubMed] [Google Scholar]
  5. DeRemee R. A. Sarcoidosis. Mayo Clin Proc. 1995 Feb;70(2):177–181. doi: 10.4065/70.2.177. [DOI] [PubMed] [Google Scholar]
  6. Hillerdal G., Nöu E., Osterman K., Schmekel B. Sarcoidosis: epidemiology and prognosis. A 15-year European study. Am Rev Respir Dis. 1984 Jul;130(1):29–32. doi: 10.1164/arrd.1984.130.1.29. [DOI] [PubMed] [Google Scholar]
  7. Hosenpud J. D., Bennett L. E., Keck B. M., Fiol B., Novick R. J. The Registry of the International Society for Heart and Lung Transplantation: fourteenth official report--1997. J Heart Lung Transplant. 1997 Jul;16(7):691–712. [PubMed] [Google Scholar]
  8. Johnson B. A., Duncan S. R., Ohori N. P., Paradis I. L., Yousem S. A., Grgurich W. F., Dauber J. H., Griffith B. P. Recurrence of sarcoidosis in pulmonary allograft recipients. Am Rev Respir Dis. 1993 Nov;148(5):1373–1377. doi: 10.1164/ajrccm/148.5.1373. [DOI] [PubMed] [Google Scholar]
  9. Kazerooni E. A., Cascade P. N. Recurrent miliary sarcoidosis after lung transplantation. Radiology. 1995 Mar;194(3):913–913. doi: 10.1148/radiology.194.3.7863002. [DOI] [PubMed] [Google Scholar]
  10. Khaghani A., Banner N., Ozdogan E., Musumeci F., Theodoropoulos S., Aravot D., Fitzgerald M., Yacoub M. Medium-term results of combined heart and lung transplantation for emphysema. J Heart Lung Transplant. 1991 Jan-Feb;10(1 Pt 1):15–21. [PubMed] [Google Scholar]
  11. Madden B., Radley-Smith R., Hodson M., Khaghani A., Yacoub M. Medium-term results of heart and lung transplantation. J Heart Lung Transplant. 1992 Jul-Aug;11(4 Pt 2):S241–S243. [PubMed] [Google Scholar]
  12. Martinez F. J., Orens J. B., Deeb M., Brunsting L. A., Flint A., Lynch J. P., 3rd Recurrence of sarcoidosis following bilateral allogeneic lung transplantation. Chest. 1994 Nov;106(5):1597–1599. doi: 10.1378/chest.106.5.1597. [DOI] [PubMed] [Google Scholar]
  13. McCarthy P. M., Starnes V. A., Theodore J., Stinson E. B., Oyer P. E., Shumway N. E. Improved survival after heart-lung transplantation. J Thorac Cardiovasc Surg. 1990 Jan;99(1):54–60. [PubMed] [Google Scholar]
  14. Oni A. A., Hershberger R. E., Norman D. J., Ray J., Hovaguimian H., Cobanoglu A. M., Hosenpud J. D. Recurrence of sarcoidosis in a cardiac allograft: control with augmented corticosteroids. J Heart Lung Transplant. 1992 Mar-Apr;11(2 Pt 1):367–369. [PubMed] [Google Scholar]
  15. Orens J. B., Becker F. S., Lynch J. P., 3rd, Christensen P. J., Deeb G. M., Martinez F. J. Cardiopulmonary exercise testing following allogeneic lung transplantation for different underlying disease states. Chest. 1995 Jan;107(1):144–149. doi: 10.1378/chest.107.1.144. [DOI] [PubMed] [Google Scholar]
  16. Scott J., Higenbottam T. Transplantation of the lungs and heart and lung for patients with severe pulmonary complications from sarcoidosis. Sarcoidosis. 1990 Mar;7(1):9–11. [PubMed] [Google Scholar]
  17. Weissler J. C. Southwestern internal medicine conference: sarcoidosis: immunology and clinical management. Am J Med Sci. 1994 Mar;307(3):233–245. doi: 10.1097/00000441-199403000-00012. [DOI] [PubMed] [Google Scholar]
  18. Yeatman M., McNeil K., Smith J. A., Stewart S., Sharples L. D., Higenbottam T., Wells F. C., Wallwork J. Lung Transplantation in patients with systemic diseases: an eleven-year experience at Papworth Hospital. J Heart Lung Transplant. 1996 Feb;15(2):144–149. [PubMed] [Google Scholar]

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