Heart-lung transplantation for primary pulmonary hypertension

被引:35
作者
Whyte, RI
Robbins, RC
Altinger, J
Barlow, CW
Doyle, R
Theodore, J
Reitz, BA
机构
[1] Stanford Univ, Falk Cardiovasc Res Ctr, Sch Med, Dept Cardiothorac Surg, Stanford, CA 94305 USA
[2] Stanford Univ, Dept Med, Div Pulm & Crit Care Med, Stanford, CA 94305 USA
关键词
D O I
10.1016/S0003-4975(99)00176-9
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. The operation of choice for primary pulmonary hypertension remains controversial, as heart-lung transplantation, single-lung transplantation, and double-lung transplantation have all been advocated. Methods. We reviewed our institution's experience with heart-lung transplantation for primary pulmonary hypertension. Results. Thirty-nine patients had heart-lung transplantation for primary pulmonary hypertension. Operative mortality rate was 18%, and actuarial survival was 72% at 1 year, 67% at 2 years, and 42% at 5 years. Freedom from obliterative bronchiolitis was 91% at 1 year, 83% at 2 years, and 70% at 5 years. Freedom from obliterative bronchiolitis-related death was 100% at 1 year, 90% at 2 years, and 87% at 5 years. Freedom from accelerated graft coronary disease was 92% at 5 years. The most frequent causes of death were infection, obliterative bronchiolitis, and accelerated graft coronary disease, Conclusions. Heart-lung transplantation results in survival comparable to that reported for single or double lung transplantation. Obliterative bronchiolitis is a significant cause of late death but seems to occur less frequently with heart-lung transplantation than with lung transplantation alone. Accelerated coronary graft disease is rare in the first 5 years after transplantation. (Ann Thorac Surg 1999;67:937-42) (C) 1999 by The Society of Thoracic Surgeons.
引用
收藏
页码:937 / 941
页数:5
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