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[Heart-lung transplantation].

J Cerrina, P Dartevelle, G Simonneau

    Revue Des Maladies Respiratoires
    |January 1, 1987
    PubMed
    Summary
    This summary is machine-generated.

    Combined heart-lung transplants offer advantages over single lung transplants for specific conditions like pulmonary hypertension. This complex procedure requires careful surgical technique and donor matching, with potential complications to manage.

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    Area of Science:

    • Cardiovascular Surgery
    • Thoracic Transplantation
    • Pulmonary Medicine

    Context:

    • Heart-lung transplantation, pioneered in 1982, is increasingly favored over isolated lung transplantation.
    • Expanded indications include terminal heart failure with fixed pulmonary arterial hypertension.
    • Addresses limitations of single lung transplants, such as tracheal anastomosis healing and ventilation/perfusion mismatch.

    Purpose:

    • To review the advantages of combined heart-lung transplantation compared to isolated lung transplantation.
    • To discuss the surgical challenges and donor limitations associated with cardiopulmonary transplantation.
    • To outline the postoperative complications and long-term outcomes of this procedure.

    Summary:

    • Heart-lung transplants demonstrate superiority in tracheal anastomosis healing, rejection detection via endomyocardial biopsy, and improved ventilation/perfusion matching.

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  • Surgical complexities include preserving mediastinal nerves and managing hemorrhage risks.
  • Donor availability is limited by thoracic cage size compatibility and absence of pulmonary infection/trauma.

    • Impact:

    • Potential to improve outcomes for patients with end-stage heart failure and pulmonary hypertension.
    • Highlights the need for specialized surgical expertise and donor networks.
    • Identifies key postoperative and late complications, including hemorrhage, rejection, edema, infection, atherosclerosis, and bronchiolitis obliterans.