Surfactant as salvage therapy in life threatening primary graft dysfunction in lung transplantation

Anat Amital, David Shitrit, Yael Raviv, Milton Saute, Ilana Bakal, Benjamin Medalion, Mordechai R. Kramer

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Objective: Impaired surfactant activity may contribute to primary graft dysfunction after lung transplantation. We assessed the role of surfactant treatment in lung transplant recipients with severe life threatening primary lung graft dysfunction. Patients and methods: Five patients after lung transplantation: 4 after single-lung transplantation, for emphysema (n = 3) or idiopathic pulmonary fibrosis (n = 1), and 1 patient after double-lung transplantation for cystic fibrosis. All had severe life threatening primary graft dysfunction that failed to respond to conventional measures. Treatment consisted of bronchoscopic instillation of mammalian surfactant, 20-90 cc, at 3 (n = 1) or 7 days (n = 4) after transplantation. Results: There was a significant improvement in the ratio of partial arterial oxygen tension (PaO2) to fractional concentration of oxygen in inspired gas (FIO2), from a mean of 98.8 ± 21.7 to 236.8 ± 52.3 mmHg (p = 0.0006), within hours of treatment. All were eventually discharged home and showed a satisfactory FEV1 (44-67% predicted) at the 6-month follow-up. All patients were still alive 6 months or more after transplantation. Conclusion: Surfactant treatment improves oxygenation and may be life saving in patients with primary lung graft dysfunction.

Original languageEnglish
Pages (from-to)299-303
Number of pages5
JournalEuropean Journal of Cardio-thoracic Surgery
Issue number2
StatePublished - 1 Feb 2009
Externally publishedYes


  • Lung transplantation
  • Primary graft dysfunction
  • Surfactant

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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