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Transplant
Unit and Departments of Diagnostic Imaging and Pathology, Harefield
Hospital, Harefield, Middlesex UB9 6JH, UK
Correspondence to: Dr S Walker, Department of Cardiology, Harefield Hospital, Harefield, Middlesex UB9 6JH, UK.
Received 4 September 1997; Returned to authors 1 December 1997; Revised version received 5 January 1998; Accepted for publication 6 January 1998
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.
METHODSThis 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.
RESULTSSurvival 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.
CONCLUSIONSLung 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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