title: Management following heart and lung transplantation: five years experience.
abstract: Since April 1984, 70 patients have received heart-lung transplants at our institution. Actuarial survival is 76% at 1 year and 68% at 2 years. All but 4 surviving patients have an unrestricted life style. Rejection was confirmed by lung transbronchial biopsy (TBB) on 277 occasions in 66 patients. Forty-two percent of episodes occurred within 1 month of surgery. Eight patients have developed evidence of chronic rejection with progressive irreversible fall in FEV1, of whom 4 have died or undergone single lung retransplantation. Seven patients had primary cytomegalovirus (CMV) of whom 4 patients died. Eight patients developed pneumocystis pneumonia of whom 1 died. Seven episodes of herpes simplex pneumonitis occurred of which one episode was fatal. Heart-lung transplantation is a valuable treatment for terminal cardiopulmonary disease and offers increasing hope of long-term survival.
authors.affiliation: Heart-Lung Transplant Research Unit, Papworth Hospital, Cambridge, UK.
authors.forename: J P
authors.initials: JP
authors.lastname: Scott
authors.forename: G
authors.initials: G
authors.lastname: Fradet
authors.forename: R L
authors.initials: RL
authors.lastname: Smyth
authors.forename: E
authors.initials: E
authors.lastname: Solis
authors.forename: T W
authors.initials: TW
authors.lastname: Higenbottam
authors.forename: J
authors.initials: J
authors.lastname: Wallwork
mesh_terms: D001706:Biopsy; D003586:Cytomegalovirus Infections / Q000209:etiology; D006084:Graft Rejection; D016041:Heart-Lung Transplantation / Q000401:mortality; D006801:Humans; D008171:Lung Diseases / Q000209:etiology; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control