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Human lung transplantation

J M Nelems, A S Rebuck, J D Cooper

    Chest
    |October 1, 1980
    PubMed
    Summary
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    This study details the 38th human lung transplant, focusing on innovative techniques like extracorporeal membrane oxygenation and platelet function control. The primary challenge identified for future lung transplants is establishing adequate bronchial arterial supply.

    Area of Science:

    • Thoracic Surgery
    • Transplantation Medicine
    • Pulmonary Medicine

    Background:

    • Describes the 38th human lung allotransplantation in a patient with smoke inhalation injury.
    • Highlights innovative surgical and perioperative management strategies employed during the procedure.

    Observation:

    • The patient received prolonged extracorporeal membrane oxygenation (ECMO) support.
    • Pharmacologic control of platelet function using sulfinpyrazone was implemented.
    • Continuous monitoring was achieved with a fiberoptic ear oximeter.
    • The transplanted lung was pretreated with cytotoxic drugs.

    Findings:

    • The patient survived for 18 postoperative days without evidence of tissue rejection.
    • Death occurred due to ischemic disruption of the bronchial anastomosis.

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  • No signs of immunological rejection were observed.

    • Implications:

    • Successful management of immunological aspects of lung transplantation was demonstrated.
    • The critical role of bronchial arterial supply for graft survival is highlighted.
    • Future research should focus on vascularization techniques for bronchial anastomosis in lung transplantation.