Both single and bilateral lung transplantation are suitable technical alternatives for which of the following conditions?

A. Obstructive lung disease (chronic obstructive pulmonary disease, emphysema).

B. Restrictive lung disease (pulmonary fibrosis).

C. Primary pulmonary hypertension.

DISCUSSION: Single-lung transplantation is inappropriate for cystic fibrosis or for any patient with chronic bilateral pulmonary sepsis. Leaving a septic native lung in situ in an immunocompromised patient would leave the patient at risk for local and systemic septic complications. Single-lung transplantation with contralateral pneumonectomy would be associated with a high risk of empyema in the pneumonectomy space and also disruption of the bronchial stump. Both single- and bilateral lung transplantation have been applied successfully in all of the other disease categories listed here.