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Long-term cardiopulmonary function after human heart-lung transplantation
A R Glanville1, J C Baldwin, S A Hunt
1Respiratory Medicine, Concord Hospital, NSW.
Australian and New Zealand Journal of Medicine
|June 1, 1990
Summary
Heart-lung transplant (HLT) recipients show preserved cardiac function but frequent pulmonary issues like airflow limitation. Regular pulmonary function tests are valuable, but invasive cardiac monitoring is not needed annually for long-term survivors.
Area of Science:
- Cardiology
- Pulmonology
- Transplant Surgery
Background:
- Heart-lung transplantation (HLT) is a treatment for end-stage pulmonary hypertension.
- Long-term outcomes and functional status post-HLT require ongoing evaluation.
Purpose of the Study:
- To assess cardiac and pulmonary function in HLT recipients up to four years post-transplant.
- To identify factors influencing long-term survival and complications.
Main Methods:
- Serial annual reviews of 21 HLT recipients.
- Cardiac catheterization and endomyocardial biopsies.
- Pulmonary function testing.
Main Results:
- No biopsy-proven rejection; low incidence of coronary artery disease and pulmonary hypertension.
- Common findings include systemic hypertension and airflow limitation (reduced FEV1/FVC ratio and FEF25-75).
- Survival strongly correlated with resting PaO2 and pulmonary function parameters; obliterative bronchiolitis (OB) was a significant cause of mortality.
Conclusions:
- HLT recipients maintain cardiac function and coronary patency long-term, without severe OB.
- Regular pulmonary function testing is crucial for monitoring.
- Annual invasive cardiac monitoring is not indicated for stable long-term HLT survivors.