Heart and heart-lung transplantation, Papworth Hospital, 1979-1989.
The quality of life for those who survive the first 3 months after transplantation is generally good (10). The duration of hospital stay and the cost of transplantation per patient has been reduced during the last 3 years. Cardiologists are coming to appreciate the therapeutic potential of both heart and heart-lung transplantation. One of the chief logistical problems now being faced is that of increasing the provision of transplant services to match the increasing demand. It was said in an earlier edition of this book that this would be donor organ limited and that pattern already seen in the United States is becoming apparent in the United Kingdom. The broad principles of management of heart and heart-lung recipients have been established. Further improvements in medium and long-term results can be anticipated as a result of refining immunosuppression and defining the cause of chronic donor organ related damage (small vessel coronary occlusive disease in heart transplants and chronic obliterative bronchiolitis in heart-lung transplants). Heart transplantation has become firmly established as a therapeutic option for life threatening heart disease. It is probably too early to attribute this label to heart-lung transplantation which continues through its developmental phase with acceptable short-term results. Improvements in chronic damage characteristic of long-term survival in both heart and heart-lung transplant recipients will be a significant clinical step forward in this field.
Large
S R
SR
Papworth Hospital, Cambridge, England.
English
T A
TA
Wallwork
J
J
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006084:Graft Rejection; D016027:Heart Transplantation / Q000276:immunology / Q000401:mortality; D016041:Heart-Lung Transplantation / Q000276:immunology / Q000401:mortality; D006801:Humans; D007165:Immunosuppression Therapy; D008297:Male; D008875:Middle Aged