title: [Clinical applications of the heart-lung transplant. Clinical results 5 years after the start of the program at Papworth].
abstract: In this study is reviewed the experience at Papworth Hospital, Cambridgeshire, and Great Ormond Street Hospital, London, with combined heart-lung transplantation. Between April 1984 and June 1989, 73 patients have undergone heart-lung transplantation. Donors and recipients were carefully matched with regards to serology, morphology and cytomegalovirus compatibility. Heart preservation was based on use of cold St. Thomas' cardioplegic solution; a pulmonary preservation fluid has been developed that allows distant organ procurement with a single pulmonary artery flush technique (Papworth solution). The recipients were: 21 pts with Eisenmenger's syndrome, 15 pts with pulmonary hypertension, 37 pts with pulmonary disease (including 22 cystic fibrosis). The results are: no surgical mortality; no acute cardiac rejection episodes. Twenty-three patients died (16 with infections, 3 with obliterative bronchiolitis, 2 with cerebral embolism and 2 others). The actuarial survival rate at one year is 73.2%; 63% at two years and 47.4% at four years. The use of transbronchial biopsy of the lung has provided accurate early and safe diagnosis of pulmonary rejection. Development in organ preservation and patient management, as well as careful selection of recipients and donors, have led to the effective use of resources and thereby to these good results.
authors.affiliation: Heart-Lung Transplant Research Unit, Papworth Hospital, Cambridge, Great Britain.
authors.forename: A
authors.initials: A
authors.lastname: Fabbri
authors.forename: J
authors.initials: J
authors.lastname: Scott
authors.forename: J
authors.initials: J
authors.lastname: McGoldrick
authors.forename: R
authors.initials: R
authors.lastname: Smyth
authors.forename: G
authors.initials: G
authors.lastname: Fradet
authors.forename: T
authors.initials: T
authors.lastname: Higenbottam
authors.forename: M
authors.initials: M
authors.lastname: De Leval
authors.forename: J
authors.initials: J
authors.lastname: Wallwork
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000601:surgery*; D004541:Eisenmenger Complex / Q000601:surgery*; D004739:England; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D016041:Heart-Lung Transplantation; D006801:Humans; D006976:Hypertension, Pulmonary / Q000601:surgery*; D008297:Male; D008875:Middle Aged
vernacular_title: Applicazione clinica del trapianto cuore-polmone. Risultati clinici a cinque anni dall'avvio del programma a Papworth.