Klepetko W, Wollenek G, Laczkovics A, Laufer G, Wolner E
Second Surgical Department, University of Vienna, Austria.
J Heart Lung Transplant. 1991 Jan-Feb;10(1 Pt 1):129-31.
The scarcity of donor organs remains the main restricting factor for heart, heart-lung, and lung transplantation. Recently new techniques for separate harvesting of the heart and the lungs from one donor for two recipients have been developed. These techniques enable the optimal use of available grafts. Another approach to this problem is combined heart-lung transplantation for patients with end-stage lung disease but still adequate heart performance, and the subsequent transplantation of the recipient's heart into a second patient with end-stage heart disease. The main advantages of this procedure are its technical simplicity compared with double lung transplantation; the preservation of aortobronchial collaterals, resulting in improved blood supply to the trachea; and the possibility of transplanting a conditioned right heart well adapted to chronically elevated pulmonary pressure. We recently have performed this procedure with good clinical results and suggest it as the method of choice whenever two well-matched recipients are available.
供体器官的稀缺仍然是心脏、心肺和肺移植的主要限制因素。最近，已开发出从一名供体为两名受者分别获取心脏和肺的新技术。这些技术能够最佳地利用可用的移植物。解决这个问题的另一种方法是为终末期肺病但心脏功能仍正常的患者进行心肺联合移植，然后将受者的心脏移植给另一名终末期心脏病患者。该手术的主要优点是与双肺移植相比技术简单；保留主动脉支气管侧支，从而改善气管的血液供应；以及有可能移植适应长期升高的肺动脉压的经适应的右心。我们最近进行了该手术，取得了良好的临床效果，并建议在有两名匹配良好的受者时将其作为首选方法。
