Héritier F, Madden B, Hodson M E, Yacoub M
National Heart and Lung Institute, London, UK.
Eur Respir J. 1992 Nov;5(10):1262-78.
In spite of a shortage of available donors, an increasing number of heart-lung transplantations have been performed within the last decade. This procedure, first limited to patients with pulmonary vascular disease, has been successfully extended to patients with end stage lung disease, including cystic fibrosis. More recently, single lung, double-lung and bilateral single lung transplantation have become other therapeutic options. Better selection of patients and donors as well as improvements in surgical techniques and immunosuppression regimens have contributed to the reduction in the high perioperative mortality experienced in the early stages. Moreover, the introduction of daily spirometry and transbronchial lung biopsies have permitted early and reliable diagnosis of opportunistic infection and rejection. The most serious late complication of lung transplantation is obliterative bronchiolitis and further research is urgently required to improve diagnosis and management of this condition.
尽管可用供体短缺，但在过去十年中，心肺移植手术的数量仍在不断增加。该手术最初仅限于患有肺血管疾病的患者，现已成功扩展至患有终末期肺病（包括囊性纤维化）的患者。最近，单肺移植、双肺移植和双侧单肺移植也成为了其他治疗选择。对患者和供体的更好选择以及手术技术和免疫抑制方案的改进，有助于降低早期围手术期的高死亡率。此外，每日肺功能测定和经支气管肺活检的引入，使得能够早期且可靠地诊断机会性感染和排斥反应。肺移植最严重的晚期并发症是闭塞性细支气管炎，迫切需要进一步研究以改善对该病症的诊断和管理。
