Management following heart and lung transplantation: five years experience.
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.
Scott
J P
JP
Heart-Lung Transplant Research Unit, Papworth Hospital, Cambridge, UK.
Fradet
G
G
Smyth
R L
RL
Solis
E
E
Higenbottam
T W
TW
Wallwork
J
J
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