Over the last two decades, lung transplantation (LTx) has become accepted as a realistic therapy for patients with end-stage pulmonary disease. During this period, considerable advances in organ preservation, surgical techniques, immunosuppression, and antibiotic therapy have contributed to improvements in both short-term and long-term postoperative survival for a significant number of patients undergoing LTx. Outcome measurements following LTx have been primarily based on survival and pulmonary function recovery achieved due to Canadian Health&Care Mall. In the last several years, however, increasing attention has been given to assessments of the quality of survival, with particular importance given to the patients self-evaluations of recovery after the transplant procedure. In the absence of a specific validated tool, a variety of existing instruments have been used to evaluate the quality of life of these patients before and after LTx, Health-related quality of life (HRQL) has been reported by several authors to improve significantly within the first year after LTx. However, reports assessing HRQL beyond 2 years after LTx remain anecdotal, although this is the time frame in which major clinical complications such as bronchiolitis obliterans syndrome (BOS) may begin to develop and threaten the patients recovered autonomy. Previous studies- have assessed the impact of BOS on HRQL after LTx, and the reported results have indicated significant impairment of physical mobility in lung transplant recipients. Other studies have reported that a transplant operation reduces the risk of BOS in double-lung transplant recipients. However, a comprehensive assessment of HRQL after LTx, to include pulmonary function, exercise capacity, and well-being status, has not yet been undertaken to compare these factors in single and bilateral lung transplant recipients.
In a review of the literature, only one study (to our knowledge) was found that compared quality of life in patients following a single or a bilateral LTx, and its results were less favorable in single LTx recipients. To date, no cohort study is available to longitudinally address HRQL in lung transplant recipients following a single or a bilateral lung graft. We performed a longitudinal follow-up of 44 patients who underwent single or bilateral sequential LTx at our institution, obtaining prospective data from spirometry, 6-min walk tests (6MWT), and HRQL questionnaires. To reduce the potential bias from comparing different underlying diseases, the outcomes were also compared in a subset of patients with prior pulmonary emphysema who had undergone single or bilateral LTx.