| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
The Journal of Thoracic and Cardiovascular Surgery, Vol 99, 54-59, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
PM McCarthy, VA Starnes, J Theodore, EB Stinson, PE Oyer and NE Shumway
Sixty-two patients underwent 65 heart-lung transplant operations before
April 1989. Thirty of these patients (operated on March 1981 to February
1986) were given cyclosporine and prednisone for immunosuppression. These
30 patients (group 1) are compared with the 32 most recent patients (group
2) treated with cyclosporine, prednisone, and azathioprine. Patient
characteristics (group 1 versus group 2) were similar including age (mean
32 versus 26 years) and indication for operation (51% versus 38%, primary
pulmonary hypertension; 46% versus 45%, Eisenmenger complex; 3% versus 17%,
other). The perioperative (in- hospital) mortality rate was 35% in group 1
versus 16% in group 2. Obliterative bronchiolitis developed in 12 (63%) of
19 hospital survivors in group 1 from 2 months to 49 months postoperatively
(mean 12 months). This complication has developed in five (20%) of the 25
hospital survivors in group 2 from 3 to 13 months postoperatively (mean 8
months). Overall, 24 of the 30 patients in group 1 died (infection in
eight, obliterative bronchiolitis in five, graft coronary artery disease in
two, other causes in nine). Eight of the 32 patients in group 2 died
(infection in six, other cases in two). Survival rates for group 1 patients
were 60% at 1 year, 50% at 2 years, 43% at 3 years, and 25% at 5 years.
Survival rates for group 2 patients were 73% at 1 year, 73% at 2 years, and
65% at 3 years (p less than 0.05). When group 2 patients were compared with
134 patients undergoing heart transplantation during the same time period,
there was no difference in survival. Routine bronchoscopic surveillance in
the more recent group of patients has led to the earlier detection of
rejection and infection. In combination with decreased perioperative
mortality and augmented immunosuppression, this had led to improved
survival in our more recent heart-lung transplant recipients. In addition,
the earlier recognition of infection and rejection has led to a decrease in
severity of obliterative bronchiolitis.
ARTICLES
Improved survival after heart-lung transplantation
Department of Cardiovascular Surgery, Stanford University Medical Center, CA 94305.
This article has been cited by other articles:
|
|
 |
|
  C. K. Choong, S. C. Sweet, T. J. Guthrie, E. N. Mendeloff, F. J. Haddad, P. Schuler, M. D. L. Morena, and C. B. Huddleston Repair of congenital heart lesions combined with lung transplantation for the treatment of severe pulmonary hypertension: A 13-year experience J. Thorac. Cardiovasc. Surg., March 1, 2005; 129(3): 661 - 669. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Gridelli and G. Remuzzi Strategies for Making More Organs Available for Transplantation N. Engl. J. Med., August 10, 2000; 343(6): 404 - 410. [Full Text] [PDF]
|
|
|
|
 |
|
 M. W. Gerbase, D. Dubois, C. Rothmeier, A. Spiliopoulos, W. Wunderli, and L. P. Nicod Costs and Outcomes of Prolonged Cytomegalovirus Prophylaxis to Cover the Enhanced Immunosuppression Phase Following Lung Transplantation Chest, November 1, 1999; 116(5): 1265 - 1272. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. P. Neuringer, R. B. Mannon, T. M. Coffman, M. Parsons, K. Burns, J. R. Yankaskas, and R. M. Aris Immune Cells in a Mouse Airway Model of Obliterative Bronchiolitis Am. J. Respir. Cell Mol. Biol., September 1, 1998; 19(3): 379 - 386. [Abstract] [Full Text]
|
|
|
|
 |
|
 S. Walker, G. Mikhail, N. Banner, J. Partridge, A. Khaghani, M. Burke, and M. Yacoub Medium term results of lung transplantation for end stage pulmonary sarcoidosis Thorax, April 1, 1998; 53(4): 281 - 284. [Abstract] [Full Text]
|
|
|
|
 |
|
 E. P. Chen, H. B. Bittner, D. M. Craig, R. D. Davis Jr, and P. Van Trigt III Pulmonary Hemodynamics and Blood Flow Characteristics in Chronic Pulmonary Hypertension Ann. Thorac. Surg., March 1, 1997; 63(3): 806 - 813. [Abstract] [Full Text]
|
|
|
|
 |
|
 M. K. Pasque, E. P. Trulock, J. D. Cooper, A. N. Triantafillou, C. B. Huddleston, M. Rosenbloom, S. Sundaresan, J. L. Cox, and G. A. Patterson Single Lung Transplantation for Pulmonary Hypertension : Single Institution Experience in 34 Patients Circulation, October 15, 1995; 92(8): 2252 - 2258. [Abstract] [Full Text]
|
|
|
|
|
|
K. Bando, I. L. Paradis, S. Similo, H. Konishi, K. Komatsu, T. G. Zullo, S. A. Yousem, J. M. Close, A. Zeevi, R. J. Duquesnoy, et al. Obliterative bronchiolitis after lung and heart-lung transplantationAn analysis of risk factors and management J. Thorac. Cardiovasc. Surg., July 1, 1995; 110(1): 4 - 14. [Abstract] [Full Text]
|
|
|
|
|
|
R. J. Novick, H.-J. Schafers, L. Stitt, B. Andreassian, W. Klepetko, R. L. Hardesty, A. Frost, and G. A. Patterson Seventy-two Pulmonary Retransplantations for Obliterative Bronchiolitis: Predictors of Survival Ann. Thorac. Surg., July 1, 1995; 60(1): 111 - 116. [Abstract] [Full Text]
|
|
|
|
|
|
R. J. Novick, B. Andreassian, H.-J. Schafers, A. Haverich, G. A. Patterson, M. P. Kaye, A. H. Menkis, and F. N. McKenzie Pulmonary retransplantation for obliterative bronchiolitis:Intermediate-term results of a North American-European series J. Thorac. Cardiovasc. Surg., March 1, 1994; 107(3): 755 - 763. [Abstract] [Full Text]
|
|
|
|
|
|
S. E. Weinberger Recent Advances in Pulmonary Medicine- Second of Two Parts N. Engl. J. Med., May 20, 1993; 328(20): 1462 - 1470. [Full Text]
|
|
|
|
 |
|
 H. I. Palevsky and A. P. Fishman The Management of Primary Pulmonary Hypertension JAMA, February 27, 1991; 265(8): 1014 - 1020. [Abstract] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
