Lung and heart-lung transplantation at the University of Pittsburgh: 1982-2002.
The University of Pittsburgh lung transplantation program began in 1982 and through 2002 we have performed 576 lung and 101 heart-lung transplants. One-, 3- and 5-year survival rates over the past decade have been 77%, 62% and 55%, respectively, comparing favorably to ISHLT registry outcomes of 73%, 57% and 46%. We continue to utilize a very thorough evaluation process but have been flexible and aggressive with potential recipients with regard to age, coronary artery disease and disease state (eg., scleroderma). Despite worldwide progress in the field of lung transplantation, many difficulties remain. The limited number of lungs deemed acceptable for transplantation continues to hinder application to a greater number of patients. Our efforts in this regard have focused on cooperation with our OPO in education and detailed donor management protocols. Chronic rejection also remains a major difficulty frequently leading to death. Recent work utilizing aerosol cyclosporine in patients with established chronic rejection suggests that this therapy may prolong life. We are also hopeful that recently initiated therapies utilizing T-cell induction strategies may contribute to further improvement in outcomes.
Gilbert
Sebastien
S
Division of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvannia, USA.
Dauber
James H
JH
Hattler
Brack G
BG
Ristich
Julianne
J
Zaldonis
Diana
D
Iacono
Aldo T
AT
Boujoukos
Arthur J
AJ
Johnson
B
B
McCurry
Kenneth R
KR
D001926:Brain Death; D006084:Graft Rejection / Q000453:epidemiology; D016027:Heart Transplantation / Q000379:methods / Q000706:statistics & numerical data*; D016041:Heart-Lung Transplantation / Q000379:methods / Q000706:statistics & numerical data*; D006785:Hospitals, University; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D019520:Living Donors / Q000706:statistics & numerical data; D008171:Lung Diseases / Q000145:classification / Q000601:surgery; D008875:Middle Aged; D018579:Patient Selection; D010414:Pennsylvania; D014019:Tissue Donors / Q000706:statistics & numerical data
D007166:Immunosuppressive Agents