Management following heart and lung transplantation: five years experience

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

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