[Experiences of combined heart-lung transplantations in the University Medical Center Groningen].
OBJECTIVE
Reporting the results of combined heart-lung transplantation in the University Medical Center Groningen (UMCG), the Netherlands.


METHODS
Retrospective study.


METHODS
Data were retrieved of patients who underwent a combined heart-lung transplantation in the UMCG between December 1996 and December 2007. Demographic, clinical and other relevant characteristics were recorded, as well as post-transplantation morbidity and mortality.


RESULTS
The study group consisted of 14 patients (3 men and 11 women) with a mean age of 41 years. Indications for heart-lung transplantation were: congenital heart disease complicated by pulmonary hypertension (6 patients), idiopathic pulmonary hypertension with severe right ventricle failure (4 patients), lung fibrosis with severe right ventricle failure (1 patient), cystic fibrosis with systolic left ventricle failure (1 patient), pulmonary hypertension after thoracic radiation and chemotherapy (1 patient) and re-transplantation after lung-transplant failure (1 patient). The mean waiting time prior to operation was approximately 1.5 years. 9 of the 14 patients (64%) underwent such a marked clinical deterioration during the waiting period that they were given a 'very high urgency status' for transplantation. Almost half of patients became dependent on supplementary intravenous inotropics during the waiting period. At the end of the study 6 of the 14 patients (43%) were alive, with a mean survival period of 58 months (range: 6-132). Infection was the cause of death in 4 of the 8 patients. Of the 8 deceased patients, 4 were underweight preoperatively (BMI < 18.5 kg/m2) and were cachectic. This was the case in only 1 of the 6 surviving patients.


CONCLUSIONS
A combined heart-lung transplantation is a rare operation in the Netherlands. The waiting time in this study was long and the post-transplantation mortality was high. Underweight (cachexia), a sign of a poor clinical condition, appears to be associated with mortality.
Universitair Medisch Centrum Groningen, Groningen, The Netherlands. j.brugemann@thorax.umcg.nl
Johan
J
Brügemann
Wim
W
van der Bij
Eric A M
EA
Verschuuren
Aafke A
AA
Klungel
Iwan C C
IC
van der Horst
Michiel E
ME
Erasmus
Huib A M
HA
Kerstjens
Dirk Jan
DJ
van Veldhuisen
Felix
F
Zijlstra
D000328:Adult; D002100:Cachexia / Q000150:complications*; D002423:Cause of Death; D003550:Cystic Fibrosis / Q000150:complications / Q000628:therapy; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000628:therapy; D016041:Heart-Lung Transplantation / Q000401:mortality*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000628:therapy; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011183:Postoperative Complications / Q000401:mortality*; D012189:Retrospective Studies; D015996:Survival Rate; D014850:Waiting Lists; D055815:Young Adult
D007166:Immunosuppressive Agents