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Early experience of heart-lung transplantation
R L Smyth1, T W Higenbottam, J P Scott
1Heart-Lung Transplant Research Unit, Papworth Hospital, London.
Insights
Pediatric heart-lung transplantation offers a viable treatment for children with end-stage respiratory failure. This study shows all five young patients survived and thrived post-transplant, returning to normal activities.
Area of Science:
- Pediatric surgery
- Cardiothoracic transplantation
- Pulmonology
Background:
- Children with terminal respiratory disease often face severe disability due to dyspnea and hypoxia.
- Conditions like primary pulmonary hypertension, cystic fibrosis, and Eisenmenger's syndrome can lead to end-stage respiratory failure in pediatric patients.
Purpose of the Study:
- To evaluate the outcomes of heart-lung transplantation in children with terminal respiratory disease.
- To assess the feasibility and efficacy of this procedure in a pediatric population.
Main Methods:
- Heart-lung transplantation was performed on five children under 16 years old between May 1987 and October 1988.
- Patients had diagnoses including primary pulmonary hypertension, cystic fibrosis, and Eisenmenger's syndrome.
Main Results:
- All five pediatric patients survived the surgery and remained well 5 to 17 months post-operation.
- Patients experienced a mean of 2.7 rejection episodes per child per half-year.
- Three patients had post-operative infections, including staphylococcal pneumonia and herpes simplex pneumonitis.
Conclusions:
- Heart-lung transplantation is a practical and effective treatment for children suffering from terminal respiratory failure.
- The procedure enables young patients to return to age-appropriate activities, significantly improving their quality of life.
Abstract:
We report our experience of heart-lung transplantation for the treatment of children with terminal respiratory disease. Between May 1987 and October 1988 we performed heart-lung transplantation in five children under the age of 16 (age range 11-15). All the patients were severely disabled by dyspnoea and hypoxia. Two had primary pulmonary hypertension, two cystic fibrosis, and one had Eisenmenger's syndrome. All five children are alive and well five to 17 months after operation and have returned to activities normal for their age. Three of the five patients had episodes of infection after operation. These were staphylococcal pneumonia, herpes simplex pneumonitis and, in one of the patients with cystic fibrosis, persistent purulent sputum. The mean number of episodes of rejection per child was 2.7 per half year. Heart-lung transplantation is a practical treatment for children in these disease groups with terminal respiratory failure.