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Heart-lung transplantation: initial experience in New England
G V Letsou1, K L Franco, G S Kopf
1Yale University School of Medicine.
Connecticut Medicine
|August 1, 1990
Summary
Combined heart-lung transplants offer effective therapy for end-stage cardiopulmonary disease. Four of five patients showed good graft function and improved quality of life post-transplant.
Area of Science:
- Cardiology
- Pulmonology
- Transplant Surgery
Background:
- Five patients with end-stage cardiopulmonary disease underwent combined heart-lung transplantation.
- Patients presented with conditions including primary pulmonary hypertension, cystic fibrosis, and doxorubicin-induced cardiomyopathy.
- All patients had severe functional limitations and required oxygen support.
Purpose of the Study:
- To evaluate the efficacy and outcomes of combined heart-lung transplantation in patients with severe cardiopulmonary disease.
Main Methods:
- Five combined heart-lung transplants were performed between May 1988 and June 1989.
- Graft procurement included four distant and one on-site procedure with varying ischemic times.
- Postoperative assessment included oxygenation levels (PO2 on FIO2 30%) and patient extubation times.
Main Results:
- Four of five grafts demonstrated successful function with adequate postoperative oxygenation.
- One graft experienced total failure due to donor fluid overload, preventing weaning from bypass.
- All successfully transplanted patients were extubated within 24-30 hours and experienced infrequent, treatable rejection episodes.
Conclusions:
- Combined heart-lung transplantation is an effective treatment for carefully selected patients with end-stage cardiopulmonary conditions.
- The majority of patients achieved normal cardiopulmonary function and functional capacity post-transplant.
- Long-term survival and quality of life improvements were observed in surviving patients.