Geiran O, Lindberg H, Bjørtuft O, Johansen B, Simonsen S, Hysing E, Dragsund M, Foerster A, Rootwelt K, Vatne K
Department of Surgery, Rikshospitalet, Oslo, Norway.
Scand J Thorac Cardiovasc Surg. 1992;26(3):163-8. doi: 10.3109/14017439209099073.
Seven single lung transplants are reported. The patients were severely disabled and oxygen dependent below sixty years of age with a poor prognosis. Diagnosis were alfa 1-antitrypsin deficiency (3), sarcoidosis (3) and idiopathic emphysema (1). Multiorgan-harvesting including six hearts, was performed in local or distant hospitals (3). Partial cardiopulmonary bypass simplified transplantation. The surgical procedure was modified with a direct transpericardial approach. Soft tissue wrapping by a vascularized pedicle secured the bronchial anastomosis. The four drug immunosuppressive regimen included cyclosporin A, azathioprine, steroids and antithymocyte globulin. Primary graft function was excellent. Six patients survived the postoperative period and are alive 5-19 months post transplant. Transbronchial biopsies and lung function studies have been helpful in detecting pulmonary rejections. Patient rehabilitation is satisfactory in most patients with improvement in physiologic parameters.
报告了7例单肺移植病例。患者均为60岁以下严重残疾且依赖氧气、预后不良者。诊断包括α1抗胰蛋白酶缺乏症（3例）、结节病（3例）和特发性肺气肿（1例）。在当地或外地医院进行了包括6例心脏的多器官获取（3例）。部分体外循环简化了移植手术。手术方法采用直接经心包途径进行了改良。带血管蒂的软组织包裹固定支气管吻合口。四联免疫抑制方案包括环孢素A、硫唑嘌呤、类固醇和抗胸腺细胞球蛋白。移植肺原发性功能良好。6例患者术后存活，移植后5 - 19个月仍存活。经支气管活检和肺功能研究有助于检测肺部排斥反应。大多数患者的康复情况令人满意，生理参数有所改善。
