Twenty-eight cases of human heart-lung transplantation.
Between March, 1981, and August, 1985, twenty-eight heart-lung transplant operations were done in 27 patients at a single institution. 8 patients died in the perioperative period and adhesions related to previous thoracic surgery proved to be a major risk factor for postoperative haemorrhage. Obliterative bronchiolitis developed in half of the 20 long-term survivors, a mean of 11.2 months (range 2-35 months) after surgery: 4 of these patients died, 3 are functionally limited, 2 were successfully treated with corticosteroids, and the remaining patient was successfully retransplanted. The other 10 long-term survivors returned to a normal life with essentially normal pulmonary function measured at a mean of 22.6 months (range 4-42 months) after transplantation. All the surviving patients have evidence of renal impairment related to cyclosporin nephrotoxicity. The results indicate that, although heart-lung transplantation is compatible with essentially normal long-term pulmonary function, the procedure should not yet be regarded as a routine clinical intervention.
Burke
C M
CM
Theodore
J
J
Baldwin
J C
JC
Tazelaar
H D
HD
Morris
A J
AJ
McGregor
C
C
Shumway
N E
NE
Robin
E D
ED
Jamieson
S W
SW
D000402:Airway Obstruction / Q000209:etiology; D001982:Bronchial Diseases / Q000209:etiology; D003524:Cyclosporins / Q000009:adverse effects; D016027:Heart Transplantation; D016041:Heart-Lung Transplantation; D006801:Humans; D006976:Hypertension, Pulmonary / Q000601:surgery; D000860:Hypoxia / Q000209:etiology; D007674:Kidney Diseases / Q000139:chemically induced; D008168:Lung / Q000503:physiopathology; D016040:Lung Transplantation; D011183:Postoperative Complications; D012086:Reoperation; D012129:Respiratory Function Tests; D013903:Thoracic Surgery / Q000009:adverse effects; D013997:Time Factors; D000267:Tissue Adhesions / Q000209:etiology; D014184:Transplantation, Homologous / Q000401:mortality
D003524:Cyclosporins