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European Journal of Cardio-Thoracic Surgery, Vol 4, 197-200, Copyright © 1990 by European Association for Cardio-thoracic Surgery

ARTICLES

Management following heart and lung transplantation: five years experience

JP Scott, G Fradet, RL Smyth, E Solis, TW Higenbottam and J Wallwork
Heart-Lung Transplant Research Unit, Papworth Hospital, Cambridge, UK.

Since April 1984, 70 patients have received heart-lung transplants at our institution. Actuarial survival is 76% at 1 year and 68% at 2 years. All but 4 surviving patients have an unrestricted life style. Rejection was confirmed by lung transbronchial biopsy (TBB) on 277 occasions in 66 patients. Forty-two percent of episodes occurred within 1 month of surgery. Eight patients have developed evidence of chronic rejection with progressive irreversible fall in FEV1, of whom 4 have died or undergone single lung retransplantation. Seven patients had primary cytomegalovirus (CMV) of whom 4 patients died. Eight patients developed pneumocystis pneumonia of whom 1 died. Seven episodes of herpes simplex pneumonitis occurred of which one episode was fatal. Heart-lung transplantation is a valuable treatment for terminal cardiopulmonary disease and offers increasing hope of long-term survival.