Pathologic pulmonary alterations in long-term human heart-lung transplantation

Area of Science:

• Cardiology
• Pulmonology
• Transplantation Immunology

Background:

• End-stage pulmonary hypertension necessitates advanced treatment options.
• Combined heart-lung transplantation is a viable option for select patients.

Observation:

• Twenty-one patients with end-stage pulmonary hypertension received heart-lung allografts post-1980.
• Early survival exceeded 80%, with long-term survivors up to 3.5 years.
• Graft recipients experienced varied outcomes, including return to normal life and severe complications.

Findings:

• Five patients experienced perioperative mortality.
• Eleven patients achieved normal pulmonary function post-transplant.
• Five recipients developed recurrent infections, obstructive airway disease, and restrictive deficits.

Implications:

• Bronchiolitis obliterans is a significant post-transplant complication.
• Interstitial fibrosis, pleural fibrosis, and arteriosclerosis were observed.
• Understanding these complications is crucial for improving long-term heart-lung transplant outcomes.