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Related Experiment Videos

Initial experience with heart and lung transplantation.

H Reichenspurner1, J A Odell, D K Cooper

  • 1Department of Cardiothoracic Surgery and Pathology, University of Cape Town Medical School, Cape Town, Republic of South Africa.

Texas Heart Institute Journal
|January 1, 1988
PubMed
Summary

Heart-lung transplantation outcomes were studied in 12 patients. While early survival was impacted by complications, long-term survival was achieved in three patients, highlighting the procedure's potential for select cases.

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Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Immunology

Background:

  • Heart-lung transplantation is a complex procedure for end-stage cardiopulmonary diseases.
  • Early heart-lung transplant outcomes have historically faced challenges with rejection and infection.

Purpose of the Study:

  • To report the outcomes of heart-lung transplantation performed between 1983 and 1987.
  • To analyze early and late complications, including rejection and infectious causes of mortality.

Main Methods:

  • A cohort of 12 patients underwent heart-lung transplantation.
  • Immunosuppression involved cyclosporine A, azathioprine, and rabbit antithymocyte globulin, later replaced by methylprednisolone.
  • Patient data on demographics, underlying conditions, complications, and survival were retrospectively analyzed.

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Main Results:

  • The primary indications included idiopathic pulmonary hypertension and Eisenmenger's syndrome.
  • Pulmonary rejection was more frequent than cardiac rejection.
  • Early mortality (within 5 weeks) was 33% (4 patients) due to respiratory insufficiency, multiorgan failure, and liver dystrophy.
  • Late mortality (5 patients) was attributed to infectious complications.
  • Two patients required retransplantation due to tuberculosis with obliterative bronchiolitis and early pulmonary insufficiency.
  • Three patients (25%) survived long-term (10-36 months postoperatively), including one who received a retransplant.

Conclusions:

  • Heart-lung transplantation in this early era had significant early and late mortality risks.
  • Infectious complications were a major cause of late death.
  • Despite challenges, long-term survival is achievable in a subset of patients.
  • Careful patient selection and management of immunosuppression and infections are critical for improving outcomes.